HomeMy WebLinkAbout20223404.tiffRESOLUTION
RE: APPROVE AMENDMENT #1 TO CONTRACT FOR BEHAVIORAL HEALTH GRANT
PROGRAM FOR HIGH-FIDELITY WRAPAROUND PROJECT AND AUTHORIZE
CHAIR TO SIGN AND SUBMIT ELECTRONICALLY
WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
WHEREAS, the Board has been presented with Amendment #1 to Contract for the
Behavioral Health Grant Program for the High -Fidelity Wraparound Project between the County
of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County,
on behalf of the Department of Human Services, and the Colorado Department of Human
Services, Behavioral Health Administration, commencing upon full execution of signatures, and
ending June 30, 2023, with further terms and conditions being as stated in said amendment, and
WHEREAS, after review, the Board deems it advisable to approve said amendment, a
copy of which is attached hereto and incorporated herein by reference.
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of
Weld County, Colorado, that Amendment #1 to Contract for the Behavioral Health Grant Program
for the High -Fidelity Wraparound Project between the County of Weld, State of Colorado, by and
through the Board of County Commissioners of Weld County, on behalf of the Department of
Human Services, and the Colorado Department of Human Services, Behavioral Health
Administration, be, and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized
to electronically sign and submit said amendment.
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 12th day of December, A.D., 2022.
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORADO
ATTEST: d„eif,,,)�',;�
Weld County Clerk to the Board
BY:
Deputy C
S • t K. James, Chair
Mik�.nom
man, Pro- em
43005,M44PerY Buck
APPR0
y Attorney
Date of signature: 12/27/
cc:1-ISD, AcT(cP/cv)
01/i1/23
teve Moreno
Lori Saine
2022-3404
HR0094
Ccinq 5thcns23
PRIVILEGED AND CONFIDENTIAL
MEMORANDUM
DATE: December 6, 2022
TO: Board of County Commissioners — Pass -Around
FR: Jamie Ulrich, Director, Human Services
RE: Colorado Department of Human Services (CDHS)
County Behavioral Health Grant Program Contract
Amendment #1
Please review and indicate if you would like a work session prior to placing this item on the
Board's agenda.
Request Board Approval of the Department's Colorado Department of Human Services (CDHS)
County Behavioral Health Grant Program Contract Amendment #1. The Department was awarded a
grant and entered into a Contract with the Colorado Department of Human Services (CDHS) Office of
Behavioral Health (OBH) to develop and implement a High -Fidelity Wraparound (HFW) team. This
Contract is known to the Board as Tyler ID 2022-1204. This Amendment will update the budget category
totals for the duration of the Contract. The total amount awarded and scope of the project will remain the
same.
I do not recommend a Work Session. I recommend approval of this Amendment and authorize the Chair
to sign.
Approve
Recommendation
Perry L. Buck
Mike Freeman, Pro -Tern
Scott K. James, Chair
Steve Moreno
Lori Saine
Schedule
Work Session
Other/Comments:
Pass -Around Memorandum; December 6, 2022 - CMS ID 6523 Page 1
2022-3404
i2/12_ HrOO9,-/
Karla Ford
From:
Sent:
To:
Subject:
Approve
Sent from my 'Phone
Mike Freeman
Tuesday, December 6, 2O22 3:14 PM
Karla Ford
Re: Please Reply - PA FOR ROUTING: FR Behavioral Health Grant Amendment #1 (CMS
6523)
On Dec 6, 2O22, at 9:24 AM, Karla Ford <kford
weldgov.com> wrote:
Please advise if you approve recommendation. Thank you.
Karla Ford X
Office Manager, Board of Weld County Commissioners
1150 O Street, P.O. Box 758, Greeley, Colorado 80632
:: 970.336-7204 :: kford@weldgov.com :: www.weldgov.com
**Please note my working hours are Monday -Thursday 7:00a.m.-5:00p.m.**
<imageOO2. jpg>
Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for the person or entity to
which it is addressed and may contain information that is privi,'eged, 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.
From: Alison Pegg <apegg@weldgov.com>
Sent: Monday, December 5, 2O22 3:O1 PM
To: Karla Ford <kford@weldgov.com>
Cc: Bruce Barker <bbarker@weldgov.com>; Cheryl Pattelli <cpattelli@weldgov.com>; Chris D'Ovidio
<cdovidio@weldgov.com>; Esther Gesick <egesick@weldgov.com>; HS -Contract Management <HS-
ContractManagement@co.weld.co.us>; Lennie Bottorff <bottorll@weldgov.com>
Subject: PA FOR ROUTING: FR Behavioral Health Grant Amendment #1 (CMS 6523)
Hi Karla,
Please see the attached PA approved for routing to all five Commissioners: FR Behavioral Health Grant
Amendment #1 (CMS 6523).
Thank you!
Alison Pegg
Contract Management and Compliance Coordinator
Weld County Dept. of Human Services
315 N. 11th Ave., Bldg A
1
DocuSign Envelope ID: 083D3B3B-56E5-4E29-B283-2E58188DBC2D
CONTRACT AMENDMENT #1
SIGNATURE AND COVER PAGE
State Agency
Colorado Department of Human Services
Behavioral Health Administration
Original Contract Number
22 IHJA 173951
Contractor
Weld County Department of Human Services
Amendment Contract Number
23 IBEH 177620
Current Contract Maximum Amount
Initial Term
State Fiscal Year 2022 +2023 $680,165*
Extension Terms
N/A
* See Exhibit B-1 — Budget for fiscal year detail
Total for All State Fiscal Years $680,165
Contract Performance Beginning Date
May 23, 2022
Current Contract Expiration Date
June 30, 2023
THE PARTIES HERETO HAVE EXECUTED THIS AMENDMENT
Each person signing this Amendment represents and warrants that he or she is duly authorized to execute this Amendment
and to bind the Party authorizine his or her signature.
CONTRACTOR
Weld County Department of Human Services
STATE OF COLORADO
Jared Polis, Govemor
Colorado Department of Human Services
Michelle Barnes, Executive Director
r-DoeuSigned by:
Sceft k Joa,t,s
r-DocuSigned by:
Or. Atoryik, M.t attect.
E7asnpB$Bsaynai...$512IS$
By: Scott K. James, C atr of ille Hoard of Commissioners
8$t�r Behavioral Health
By: Dr. Morgan Medloc , ,
Administration
Date: 12/19/2022
12/19/2022
Date:
In accordance with §24-30-202 C.R.S., this Amendment is not valid until signed and dated below by the State Controller or an
authorized delegate.
STATE CONTROLLER
Robert Jaros, CPA, MBA, JD
,.-DocuSigned by:
'no.: Williariftson.
By:D?q�
DEnq�y
Andrea Eurich / l On1 W 1lfiainson
Amendment Effective Date: 12/20/2022
Amendment Contract Number: 23 IBEH 177620 Page 1 of 3
Rev. 1/14/19
1. PARTIES
This Amendment (the "Amendment") to the Original Contract shown on the Signature and Cover
Page for this Amendment (the "Contract") is entered into by and between the Contractor, and the
State.
2. TERMINOLOGY
Except as specifically modified by this Amendment, all terms used in this Amendment that are
defined in the Contract shall be construed and interpreted in accordance with the Contract.
3. AMENDMENT EFFECTIVE DATE AND TERM
A. Amendment Effective Date
This Amendment shall not be valid or enforceable until the Amendment Effective Date
shown on the Signature and Cover Page for this Amendment. The State shall not be bound
by any provision of this Amendment before that Amendment Effective Date, and shall have
no obligation to pay Contractor for any Work performed or expense incurred under this
Amendment either before or after of the Amendment term shown in §3.B of this Amendment.
B. Amendment Term
The Parties' respective performances under this Amendment and the changes to the Contract
contained herein shall commence on the Amendment Effective Date shown on the Signature
and Cover Page for this Amendment and shall terminate on the termination of the Contract.
4. PURPOSE
The purpose of this Contract is to provide grants to county departments of human or social services
for the expansion or improvement of local or regional behavioral health disorder treatment
programs.
The purpose of this Amendment is to replace Exhibits A, C, and F and add Exhibit B-1.
5. MODIFICATIONS
The Contract and all prior amendments thereto, if any, are modified as follows:
A. The Contract Maximum Amount table on the Contract's Signature and Cover Page is hereby
deleted and replaced with the Current Contract Maximum Amount table shown on the
Signature and Cover Page for this Amendment.
i. Note: The Contractor was permitted to invoice the full amount of $29,680 designated
for Fiscal Year 2022 upon execution of the contract. This amendment reflects an actual
accounting of expenditures in Fiscal Year 2022 (totaling ($17,110.65) and moves the
remaining $144,542.35 to Fiscal Year 2023, for a FY23 total of $663,054.35. For this
reason, the Fiscal Year 2023 encumbrance may not reflect the same dollar amount as
this contract budget, because FY22 dollars that were retained by the county are now
being added to the FY23 budget. See Exhibit C-1, Miscellaneous Provisions, for
Amendment Contract Number: 23 IBEH 177620 Page 2 of 3 Rev. 1/14/19
instructions regarding reconciliation to actual expenditures throughout the life of the
contract.
B. CHANGE Pricing/Funding — Price Structure on the Contract's Signature and Cover Page
from "Fixed Price" to "Other."
c. REPLACE Exhibit A with Exhibit A-1, attached and incorporated by reference.
D. ADD Exhibit B-1.
E. REPLACE Exhibit C with Exhibit C-1, attached and incorporated by reference.
F. REPLACE Exhibit F with Exhibit F-1, attached and incorporated by reference.
6. LIMITS ON EFFECT AND ORDER OF PRECEDENCE
This Amendment is incorporated by reference into the Contract, and the Contract and all prior
amendments or other modifications to the Contract, if any, remain in full force and effect except
as specifically modified in this Amendment. Except for the Special Provisions contained in the
Contract, in the event of any conflict, inconsistency, variance, or contradiction between the
provisions of this Amendment and any of the provisions of the Contract or any prior modification
to the Contract, the provisions of this Amendment shall in all respects supersede, govern, and
control. The provisions of this Amendment shall only supersede, govern, and control over the
Special Provisions contained in the Contract to the extent that this Amendment specifically
modifies those Special Provisions.
Amendment Contract Number: 23 IBEH 177620 Page 3 of 3 Rev. 1/14/19
Exhibit A-1
Exhibit A-1 - Statement of Work
Article 1
Purpose and Target Population
1.1 Purpose. The COVID-19 pandemic affected the behavioral health needs of Coloradans,
leading to increased incidence and prevalence of stress, anxiety, social isolation, and
financial hardship accompanied by a concurrent increased demand for behavioral health
services and support. The State's crisis hotline experienced a 30% increase in average
monthly calls and a record -breaking number of texts. Reports released early in the pandemic
by The Colorado Health Foundation, as well as national studies, indicated that COVID-19 is
impacting the behavioral health conditions of people across the country, including
Coloradans.
In June 2021, Governor Jared Polis signed Senate Bill 21-137 which created a grant program
that appropriated $9,000,000 to the Behavioral Health Administration (BHA) to provide
matching grants to County Departments of Human Services or Social Services for the
expansion or improvement of local or regional behavioral health disorder treatment
programs.
Article 2
Activities and Services
2.1 Allowable Activities: This grant funds county departments of human or social services for
the expansion or improvement of local or regional behavioral health disorder treatment
programs.
Grant recipients may use the money received through the grant program for the following
purposes:
a. peer training;
b. augmentation of direct therapy;
c. acute treatment units;
d. inpatient treatment programs;
e. outreach and education;
f. navigation or care coordination;
g. capital investments in behavioral health center infrastructure;
h. services for non -English-speaking individuals;
i. culturally responsive and attuned services;
j. suicide prevention and intervention;
Amendment Contract Number: 23 IBEH 177620 Page 1 of 4
Exhibit A-1
k. crisis response;
1. withdrawal management;
m. workforce development;
n. supporting regional service delivery; or
o. any other purposes that will expand or improve local or regional behavioral health
disorder treatment programs addressing the need areas
2.2 Work Plan
a. Contractor shall submit one or both of the following work plans to BHA within 30 days
following the execution of this Contract on the template provided by BHA:
i. Services Delivery Work Plan
1. Overview of the program - Provide a clear summary of the program
2. Services provided - Provide the list of services with a brief description for
each that are available
3. Geographic region this program serves - List the counties where
services will be provided
4. Projected number of clients served annually - Project number of clients
Contractor will serve annually
5. Target Population/Eligibility - Describe the population that will be
targeted for this program and describe the eligibility requirements that
must be met to receive services under this program
ii. Capital Investment Work Plan
1. Overview of the Project - Identify the capital expense and the service
capacity that will be created or enhanced by the project.
2. Project Timeline - timeline for completion of project including necessary
zoning, licensing, fire safety, and budgetary execution milestones
3. Clients Served - Projected number of clients receiving new or enhanced
services due to capital expenditure.
b. The activities and services identified in the Work Plan are incorporated into this Contract
by reference.
c. The Contractor shall meet with BHA quarterly to review progress on the work plan.
2.3 Annual Report. Contractor shall submit an Annual Report by June 15 annually describing:
a. Contractor's progress on the Work Plan;
b. A description of the impact of the expenditures on addressing;
c. Projected number of clients
Amendment Contract Number: 23 IBEH 177620 Page 2 of 4
Exhibit A-1
Article 3
Standards / Minimum Qualifications
3.1 Any substance use disorder treatment provider must maintain its BHA SUD treatment license
and Controlled Substance License throughout the duration of this contract.
3.2 The Contractor shall assure that subcontractors use a standardized placement protocol based
upon the most recent edition of "The ASAM Criteria," published by the American Society of
Addiction Medicine (ASAM) to accurately assess each client for the most appropriate level of
care. For individuals referred to treatment through the Criminal Justice system, the Standardized
Offender Assessment -Revised (SOA-R) shall be used.
3.3 Minimum Requirements:
a. Contractor must comply with one of the two following conditions:
i. A dedication of local funding or in -kind county resources to support the
expansion or improvement of local behavioral health disorder treatment programs,
which may be from the county's local share of the federal "American rescue plan
act of 2021," pub.L. 117-2, as the act may be subsequently amended, or other
local revenue sources; or
ii. A plan for regional collaboration between no fewer than three counties to support
the expansion or improvement of regional behavioral health disorder treatment
programs.
Article 4
Deliverables
4.1 Deliverables Table
Timeline
Deliverable (emailed to
cdhs_BHAdeliverables@state.co.us)
30 days after Contract execution
Work Plan
30 days after subcontract execution
Subcontracts
By the last working day of the month
following the end of the quarter (i.e., the
last day of October, January, and April)
and by July 20th to close the year
(contingent upon contract renewal for
following fiscal year).
Quarterly Spending Report
Amendment Contract Number: 23 IBEH 177620
Page 3 of 4
Exhibit A-1
Timeline
' Deliverable (mailed to „
cdhs_BliAdeliverables@state.co.us)
Within ten (10) days following each'
quarter ended September, December,
March, and June
SLFRF Subrecipient Quarterly Report
Workbook (if and when metric added for
Expenditure Category 1 12 Other Public Health)
July 15, 2022
BHA Annual Report
July 15; 2023
BHA Annual Report
*Deadlines occurring after June 30, 2022 are contingent upon contract renewal
The Contractor shall provide the State with information about actual expenditures quarterly in
the Expenditures Report template provided by BHA The report is dire to
cdhs BHAdeliverables(aistate co us on the last working day of the month following the end of
the quarter (i e , the last day of October, January, and April) and by July 20th to close the year
(contingent upon contract renewal for following fiscal year)
Article 5
Performance Outcome Measures
5 1 Contractor shall measure the metrics identified in the SLFRF Subrecipient Quarterly Report
Workbook, as may be amended, per the terms of Exhibit F-1, SLFRF Subrecipient Provisions
Exhibit
5 2 Contractor shall provide any other narrative or reporting required by Exhibit F-1, SLFRF
Subrecipient Provisions Exhibit, as may be amended ,
Amendment Contract Number 23 IBEH 177620 Page 4 of 4
EXHIBIT B
COLORADO
Office of Behavioral Health
Department of Human Services
EXHIBIT B -1, FY22 ANNUAL BUDGET
OBH Program
County Behavioral Health
Agency Name
Weld County Department of Human Services
Budget Period
January 2022 - June 30, 2022
Project Name
High Fidelity Wraparound
This budget reflects actual expenditures in FY22
Program Contact Name, Tide
Phone
Email
Julie Witkowski, Family Resource Division Head
970-400-6777
witkowjx@weldgov.com
Fiscal Contract Name, Title
Tammy Maurer, Fiscal Manager
Phone
970-400-6533
Email
maurertk(aweldgov.com
Date Completed
November 8, 2021
All budget numbers are estimates. Contract billing pe
will be on a cost reimbursement basis for actual exnses
EXPENDITURE CATEGORIES
Personnel: Salary/Benefits
Annual Budget
Position Title
Description of Work
Gross or Annual
Salary
Fringe
Percent of Time
on Project
Total Amount Requested
from OBH
Wraparound Supervisor
High Fidelity Wraparound Supervisor who will serve as a systems
navigator and advocate in addition to supervising the HFW team.
Annual Salary $103,331.61 estimated 30% fringe.
$ 14,474.30
$ -
100%
14,474.30
Wraparound Coordinator
Wraparound Coordinator will work to preserve and rehabilitate
families while addressing mental and behavioral health needs via the
HFW process. Performs ongoing assessment and the creation of
individualized plans based on individual and family need and with a
goal of engaging and maximizing available support systems. Annual
salary $71,485.49 with an estimated 30% fringe.
$ 2,596.45
$ -
100%
2,596.45
Personnel Services -Hourly Employees
Annual Budget
Position Title
Description of Work
Hourly Wage
Hourly Fringe
Total # of Hours
on Project
Total Amount Requested
from OBH
0.00
Total Personnel Services
(including fringe benefits)
17,071.00
Client Costs
Annual Budget
Description of Item
Rate
Quantity
Total Amount Requested
from OBH
Item
0.00
Total Client Costs
0.00
Contractors/Consultants Services (Subcontracts)
Annual Budget
Name
Description of Work
Rate
Quantity
Total Amount Requested
from OBH
0.00
Total Contract Services
0.00
Occupancy
Annual Budget
Page 1 of 2
Last update 10_06_2021
EXHIBIT B
Item
Description of Item
Rate
Quantity
Total Amount Requested
from OBH
0.00
Total Occupancy
0.00
Operating / Capital
Annual Budget
Item
Description of Item
Rate
Quantity
Total Amount Requested
from OBN
Technology -purchase
Equipment: Laptop, docking station, dual monitors, mouse, keyboard, cell phone and
desk phone. Ongoing expenses for cell and desk phones -77.98 monthly x 5 sets x 6
months. Mileage to and from client homes and community locations will be paid via
other resources. Estimated mileage will be 100/month per facilitator
$.54/mile=$2592.00 annually. Amount modified to show April -June 2022 expense.
$ 39.90
1
39.90
Total Operating
40.00
TOTAL DIRECT COSTS (TD(:)
17,11 1.00
Less: Expenses per OMB 2CFR § 200
Subcontracts in excess of $25,000
0.00
Rent
0.00
Equipment
0.00
Other Unallowable Expenses
0.00
Total Expenses per OMB
0.00
2CFR § 200
MODIFIED TOTAL
DIRECT COSTS
(MTDC')
17,111.00
Indirect Costs
Annual Budget
Item
Description of Item
Percentage
Total Amount Requested
from OBH
0%
0.00
Total Indirect
0.00
Total Amount Requested 1'r1
17,111.00
Matching Funds
Annual Budget
Matching Funds
Non -Governmental Contracts
0.00
Other State Revenue/Accrual
1,404.76
Federal Grant Funds/Accrual
0.00
Local Funds -Match
0.00
Private Grant Funds/Accrual
0.00
Public Support
0.00
Private Support
0.00
In -Kind Donations
0.00
In -Kind County Resources
0.00
Local Funds/Accrual
0.00
Other Funds (Specify below)
0.00
0.00
Total Match
1,405.00
Total Budget Yrl (Requested Amount & Match)
18,516.00
The Parties may mutually agree, in writing, to modify the Budget administratively using an OBH Budget Reallocation form
Page 2 of 2
Last update 10_06_2021
EXHIBIT B-1
COLORADO
Behavioral Health
Administration
EXHIBIT B-1, FY23 ANNUAL BUDGET
BHA Program
County Behavioral Health
Agency Name
Weld County Department of Human Services
Budget Period
July 1, 2022 - June 30, 2023
Project Name
High Fidelity Wraparound
$17,110.65 was expended in FY22. $144,542.35 of the funds originally
contracted for FY22 are now incorporated into this budget for FY23
Program Contact Name, Title
Phone
Email
Julie Witkowski, Family Resource Division Head
970-400-6777
witkowjx@weldgov.com
Fiscal Contract Name, Title
Phone
Email
Tammy Maurer, Fiscal Manager
970-400-6533
maurertkgweldgov. corn
Date Completed
Revised August 12, 2022
:All budget numbers arc estimates. Contract billing will be on a cost reimbursement basis for actual expenses incurred.
EXPENDITURE CATEGORIES
Personnel: Salary/Benefits
Annual Budget
Position Title
Description of WW ork
Gross or Annual
Salary
Fringe
e.
Percent of Time
on Project
l otal Amount Requested
from BI IA
Wraparound Facilitator-
Andrew Pittman
Wraparound Coordinator will work to preserve and rehabilitate
families while addressing mental and behavioral health needs via the
S 73,620.03
$ 25,767.01
100%
$ 99,387.04
HFW process.
Wraparound Facilitator-
Sindy Carvajal
Wraparound Coordinator will work to preserve and rehabilitate
families while addressing mental and behavioral health needs via the
$ 71,485.49
$ 25,019.92
100%
$ 96,505.41
HFW process.
Wraparound Facilitator-
Madison Otto
Wraparound Coordinator will work to preserve and rehabilitate
families while addressing mental and behavioral health needs via the
$ 72,214.36
$ 25,275.03
100%
$ 97,489.39
HFW process.
Wraparound Facilitator-
Kira Hess
Wraparound Coordinator will work to preserve and rehabilitate
families while addressing mental and behavioral health needs via the
$ 75,287.30
$ 26,350.56
100%
$ 101,637.86
HFW process.
Wraparound Supervisor
High Fidelity Wraparound Supervisor who will serve as a systems
navigator and advocate in addition to supervising the HFW team.
$ 103,331.61
$ 36,166.06
100%
$ 139,497.67
Personnel Services -Hourly Employees
Annual 13udget
Position 'title
Description of Work
Hourly Wage
Hourly Fringe
Total # of hours
on Project
total kriiuunt Requested
from 13H:1
5 -
Total Personnel Services(including fringe benefits)
S 534,517.0()
Client Costs
Annual Budget
Item
Description of Item
Rate
Quantity
Total Amount Requested
from BHA
Flex Funding
Flex funding can be used to address concrete economic needs which support
family
available.
S 1,R00 OH
50
S 75,000.00
stability and reunification with no other formal or informal resources are
Total Client Costs
S 75,000.00
Contractors/Consultants Services (Subcontracts)
annual Budget
Name
Description of Work
Rate
Quantity
I otal Anu,unt Requested
from 1311. -
Kelly Pipkins-Burt
In order to educate and train employees as well as community stakeholders and potential
$ 100 00
9
S 900.00
HFW partners, we intent to contract with Kelly Pipkins-Burt, LPC, Tier 2 Wraparound
Coach. Kelly Pipkins-Burt will offer three virtual High Fidelity Wraparound trainings for
the Weld County community. Each training will be scheduled for two hours with an hour
of preparation and planning time for each. Time is billed at $100/hr to total $900.00.
1
Last update 10_06_2021
EXHIBIT B-1
Michelle Ammerman
Provide training on the Trust Based Relational Intervention (TBRI) model to
professionals and care providers involved with children who have experienced trauma
and/or prenatal substance exposure. This training provides a foundation for
understanding how trauma impacts the development of children. It provides a foundation
for interpreting children's behavior and responding appropriately and creating a practical
framework for intervention and application. Each class session is 24 hours of training,
four hours of preparation and three hours of evaluation.
$ 130.00
24
$
3,120.00
Michelle Ammerman
Preparation and evaluation for TBRI Training
$ 55.00
7
$
385.00
Total Contract Services
$
4,405.00
Occupancy
Annual Budget
Item
Description of Item
Rate
Quantity
Total Amount Requested
from BHA
S
-
Total Occupancy
$
-
Operating / Capital
Annual Budget
Description of Item
Rate
Quantity
Total Amount Requested
from BHA
Item
Technology -purchase
Equipment: Laptop, docking station, dual monitors, mouse, keyboard, cell phone and
desk phone
$ 2,472.37
3
S
7,417.11
Telephones -monthly
Ongoing expenses for cell and desk phones -77.98 monthly x 5 sets x 12 months
$ 389.90
12
$
4,678.80
Functional Assessment
Systems
Purchase software needed to implement Empirically based assessments (CAFAS,
PECFAS, JIFF and CWL) designed to objectively determine a youth's functioning across
important life domains, match their needs with the appropriate intervention or service
program and track progress to keep outcomes driven.
$ 34,336.35
1
$
34,336.35
Professional Liability
Professional Liability Insurance for LCSW, Wraparound Supervisor
$ 200.00
1
$
200.00
Conferencing Technology
Purchase Meeting Owl for immersive virtual meetings
$ 1,500.00
1
S
1,500.00
Supplies and Marketing
General office supplies and marketing material for customer and stakeholder
$ 1,000.00
1
$
1,000.00
Total Operating
$
49,132.00
TOTAL
DIRECT COSTS ("11)(')
S
663,054.00
Less: Expenses per OMB 2C'FR § 200
Subcontracts in excess of $25,000
$
-
Rent
$
-
Equipment
S
-
Other Unallowable Expenses
$
-
Total
Expenses per OMB 2CFR § 200
S
-
MODIFIED TOTAL
DIRECT COSTS (,1ITDC)
$
663,054.00
indirect Costs
Annual Budget
Description of Item
Percentage
Total Amount
Requested from BHA
Item
(1"„
S
-
Total Indirect
$
-
Total Amount Requested lir2
$
663,054.00
Matching Funds
Annual Budget
Matching Funds
Non -Governmental Contracts
$
-
Other State Revenue/Accrual
$
2,592.00
Federal Grant Funds/Accrual
$
-
Local Funds -Match
$
-
Private Grant Funds/Accrual
$
-
Public Support
$
-
Private Support
$
-
In -Kind Donations
$
-
[In -Kind County Resources
$
8,134.09
Local Funds/Accrual
$
-
Other Funds (Specify below)
$
-
Total Match
$
10,726.00
Total
Budget Yr2
(Requested Amount & Match)
$
673,780.00
The Parties may mutually agree, in writing, to modify the Budget administratively using an BHA Budget Reallocation form
2
Last update 10_06_2021
Exhibit C-1
Exhibit C-1
Miscellaneous Provisions
I. General Provisions and Requirements
A Finance and Data Protocols
The Contractor shall comply with the Behavioral Health Administration's (BHA) most
current Finance and Data Protocols and the Behavioral Health Accounting and Auditing
Guidelines, made a part of this Contract by reference
B Marketing and Communications
The Contractor shall comply with the following marketing and communications
requirements
1 Reports or Evaluations All reports or evaluations funded by BHA must be reviewed
by BHA staff, including program, data, and communications, over a period, of no
fewer than 15 business days The Contractor may be asked to place a report or
evaluation on a BHA template and the report or evaluation is required to display the
BHA logo The Contractor shall submit the finished document to BHA in its final
format and as an editable Word or Google document
2 Press Releases All press releases about work funded by BHA must note that the
work is funded by the Colorado Department of Human Services, Behavioral Health
Administration Press releases about work funded by BHA must be reviewed by
BHA program and communications staff over a period of no fewer than five
business days
3 Marketing Materials Contractor shall include the current Colorado Department of
Human Services, Behavioral Health Administration logo on any marketing
materials, such as brochures or fact sheets, that advertise programs funded by this
Contract Marketing materials must be approved by the Contract's assigned BHA
program contract over a period of no fewer than 5 business days
4 All Other Documents All other documents published by the Contractor about its
BHA -funded work, including presentations or website content, should mention the
Colorado Department of Human Services, Behavioral Health Administration as a
funder
5 Opinion of BHA BHA may require the Contractor to add language to documents
that mention BHA reading "The views, opinions and content expressed do not
necessarily reflect the views, opinions or policies of the Colorado Department of
Human Services, Behavioral Health Administration "
Amendment Contract Number 23 IBEH 177620 Page 1 of 5
Exhibit C-1
C. Start-up Costs
If the State reimburses the Contractor for any start-up costs and the Contractor closes the
program or facility within three years of receipt of the start-up costs, the Contractor shall
reimburse the State for said start-up costs within sixty (60) days of the closure. The
Contractor is not required to reimburse the State for start-up costs if the facility or program
closure is due to BHA eliminating funding to that specific program and/or budget line item.
D. Immediate Notification of Closures / Reductions in Force
If the Contractor intends to close a facility or program, it shall notify the BHA Contracts
Unit at least five business days prior to the closure. Similarly, if the Contractor, or any sub-
contractor provider, intends to conduct a reduction in force which affects a program funded
through this contract, the Contractor shall notify the BHA Contracts Unit at least five
business days prior to the layoffs.
E. Licensing and Designation Database Electronic Record System (LADDERS)
The Contractor shall use LADDERS (http://www.colorado.gov/ladders) as needed and/or
as required by rule to submit applications for BHA licensing and designation, keep current
all provider directory details, and submit policies and procedures.
F. Contract Contact Procedure
The Contractor shall submit all requests for BHA interpretation of this Contract or for
amendments to this Contract to the BHA Contract Manager.
G. The Contractor shall comply with all the provisions and requirements of RFP IHJA
2022000092.
H. Continuity of Operations Plan
1. In the event of an emergency resulting in a disruption of normal
activities, BHA may request that Contractor provide a plan describing
how Contractor will ensure the execution of essential functions of the
Contract, to the extent possible under the circumstances of the inciting
emergency ("Continuity of Operations Plan" or "Plan").
2. The Continuity of Operations Plan must be specific and responsive to the
circumstances of the identified emergency.
3. BHA will provide formal notification of receipt of the Continuity of
Operations Plan to the Contractor.
4. The Continuity of Operations Plan will not impact or change the budget
or any other provisions of the contract, and Contractor's performance will
be held to the same standards and requirements as the original Contract
terms, unless otherwise specified in the Continuity of Operations Plan.
5. Any submitted Continuity of Operations Plan will serve as an amendment
to the contract for the timeframe identified and agreed to by BHA and the
Contractor.
Amendment Contract Number: 23 IBEH 177620 Page 2 of 5
Exhibit C-1
6. Contractor shall communicate, in a format mutually agreed upon by
BHA and Contractor staff, on a frequency that supports the monitoring of
services under the Continuity of Operations Plan. If adjustments are
needed to the Plan, such adjustments will be made in writing and
accompanied by written notice of receipt from BHA.
a. As part of the BHA/Contractor communication during the
emergency, Contractor and BHA will evaluate whether the
emergency has resolved such that normal operations may be
resumed.
b. Contractor and BHA will agree in writing when the emergency
situation is sufficiently resolved and agree to a closeout period
that is four weeks or less.
c. BHA will submit notice accepting the termination of the Continuity of
Operations Plan to the Contractor as the final action for any qualifying
emergency response.
I. Cultural Responsiveness in Service Delivery
1. The Behavioral Health Administration expects funding dollars to support equity in
access, services provided, and behavioral health outcomes among individuals of
all cultures, gender identities, sexual orientations, races, and ethnicities.
Accordingly, Contractors should collect and use data to: (1) identify priority
populations vulnerable to health disparities encompassing the contractor's entire
geographic service area (e.g., racial, ethnic, limited English speaking, indigenous,
sexual orientation, gender identity groups, etc.) and (2) implement strategies to
decrease the disparities in access, service use, and outcomes —both within those
subpopulations and in comparison to the general population.
2. One strategy for addressing health disparities is the use of the recently revised
National Standards for Culturally and Linguistically Appropriate Services in
Health and Health Care (CLAS). The U.S. Department of Health and Human
Services (HHS) Think Cultural Health website
(https://thinkculturalhealth.hhs.gov/) also features information, continuing
education opportunities, resources, and more for health and health care
professionals to learn about culturally and linguistically appropriate services, or
CLAS.
3. Contractors providing direct behavioral health prevention, treatment, or recovery
services shall submit one of the following two documents to
cdhs_BHAdeliverables(&,state.co.us by August 31 annually:
a. If a provider has completed an equity plan that identifies how they will
address health equity, they can submit the plan or;
Amendment Contract Number: 23 IBEH 177620 Page 3 of 5
Exhibit C-1
b. Submit a completed CLAS checklist that follows this HHS format:
https://thinkculturalhealth.hhs.gov/assets/pdfs/AnImplementationChecklist
fortheNationalCLASStandards.pdf
J. Prohibition on Marijuana. Funds may not be used, directly or indirectly, to purchase,
prescribe, or provide marijuana or treatment using marijuana. Treatment in this context
includes the treatment of opioid use disorder. Funds also cannot be provided to any
individual who or organization that provides or permits marijuana use for the purposes of
treating substance use or mental disorders. This prohibition does not apply to those
providing such treatment in the context of clinical research permitted by the DEA and
under an FDA -approved investigational new drug application where the article being
evaluated is marijuana or a constituent thereof that is otherwise a banned controlled
substance under federal law.
II. Use of Subcontracts.
A. Services described in this Contract may be performed by Contractor or by a subcontractor,
except where this Contract states explicitly that a service must not be subcontracted.
1. Contractor shall ensure that its subcontractors perform to the terms of this Contract.
B. Any subcontract for services must include, at a minimum, the following:
1. A description of each partner's participation
2. Responsibilities to the program (policy and/or operational)
3. Resources the subcontractor will contribute, reimbursement rates, services to be included
and processes in collecting and sharing data and the most recent CDHS version of the
HIPAA Business Associates Addendum, if this Contract contains the HIPAA Business
Associates Addendum/Qualified Service Organization Addendum as an exhibit.
C. The Contractor shall provide to BHA a copy of any proposed subcontract between the
Contractor and any potential provider of services to fulfill any requirements of this Contract, to
cdhs_BHAdeliverables@state.co.us within 30 days of subcontract execution.
D. BHA reserves the right to require the Contractor to renegotiate subcontracts where necessary
to adhere to the terms of this Contract.
E. Subcontractor/Partnership Termination. In the event where partnerships with a subcontractor
such as a treatment provider is terminated, the Contractor shall transition to a new partnership
no later than 30 days from termination to ensure continuity of care for all participants of the
program.
III. Additional Remedies
A. Duty to Act in Good Faith
The Contractor shall comply with all the provisions of this contract and its amendments, if
any, and shall act in good faith in the performance of the requirements of said contract. The
Contractor agrees that failure to act in good faith in the performance with said requirements
may result in the assessment of remedial actions, liquidated damages and/or termination of
the contract in whole or in part and/or other actions by the State as allowed by law as set forth
in this contract.
Amendment Contract Number: 23 IBEH 177620 Page 4 of 5
Exhibit C-1
B. Corrective Action
The State will notify the Contractor of non-compliance and subsequently, after consultation
with the Contractor, will establish a schedule for the Contractor to cure non-compliance. The
Contractor shall be responsible for the submission of a plan of corrective action in accordance
with said schedule. If full compliance is not achieved, or a plan of action for correction is not
submitted and approved by the State within the scheduled time frame, the State may exercise
remedies specified in the General Provisions "Remedies" section of this Contract.
IV. Financial Requirements
A. Funding Sources
1. The Contractor shall identify all funds delivered to subcontractors as state general fund,
state cash funds, or federal grant dollars in Exhibit B-1, "Budget."
2. If a Single Audit is performed in accordance with Section IV.B. above, the Contractor shall
report the amount of the federal grant identified in the budget under the CFDA number
identified on the first page of this Contract.
3. The Contractor shall communicate the CFDA number to all sub -contractors in their sub-
contracts.
B. Budget Reallocations
1. The Contractor may reallocate funds between the budget categories of this contract, up to
10% of the total contract amount, upon written approval by BHA, without a contract
amendment. Any allowable reallocation is still subject to the limitations of the
Not to Exceed and the Maximum Amount Available per Fiscal Year.
C. Payment Terms
1. The Contractor shall invoice once per fiscal year for the full amount allocated to Contractor
for that fiscal year. An invoice for FY22 may be submitted upon contract execution. An
invoice for FY23 may be submitted on or after July 1, 2022. For Contractors using a
calendar fiscal year, more invoices may be submitted to align with the calendar year's
budget.
2. On or after July 20th, BHA shall review the Contractor's final report of actual expenditures
and conduct a reconciliation between disbursements and actual expenditures.
3. Any funds disbursed from BHA to the Contractor without corresponding expenses incurred
in the previous two contract years, shall be considered unearned by the Contractor and shall
require a repayment of funds from the Contractor to the State no later than September 15th
of the following state fiscal year.
4. The Contractor shall utilize the invoice template(s) provided by BHA.
5. All payment requests shall be submitted electronically to cdhs_BHApayment@state.co.us
6. Any requests for payment received after September 10th for the prior state fiscal year cannot
be processed by BHA.
7. The State will make payment on invoices within 45 days of receipt of a correct and complete
invoice to cdhs BHApayment@state.co.us. Consequently, the Contractor must have
adequate solvency to pay its expenses up to 45 days after invoice submission to the State.
Amendment Contract Number: 23 IBEH 177620 Page 5 of 5
Exhibit F-1
COLORADO
Financial services
Depanment of Homan Sernees
Division of Contracts and Procurement
EXHIBIT F-1
SLFRF SUBRECIPIENT PROVISIONS EXHIBIT (CDHS)
This Exhibit and the Appendices hereto apply regarding the use of State and Local Fiscal Recovery
Funds (SLFRF) to comply with requirements established by the U.S. Department of Treasury and
the Colorado Department of Personnel & Administration, Office of the State Controller re the
Colorado Department of Human Services (CDHS).
This SLFRF Provisions Exhibit may supplement other Exhibit(s) to the instant Agreement. In the
event that terms on prior Exhibit(s) to the instant Agreement conflict with this SLFRF Provisions
Exhibit, this Exhibit shall control and take precedence.
The ContractorNendor/Other Agency entity with which the Colorado Department of Human
Services (CDHS) is contracting per this Agreement may be referred to as "Subrecipient" herein,
the designation per controlling law and mandates. This "Subrecipient" designation shall apply in
this context notwithstanding prior definition(s) of any entity to this agreement as "Contractor" or
any other title.
Subrecipient must agree to and comply with the terms of these SLFRF Provisions in order to
receive and use these funds. Subrecipient shall execute not only the instant Agreement, but also
specifically the Certification Agreement appendix to the instant Exhibit. A failure to also
separately execute the Certification Agreement appendix hereto shall not relieve Subrecipient of
the rules/obligations set forth herein; such a clerical error must be promptly remedied upon
discovery by notifying the CDHS office/program contact, who can then assist with the logistics of
mandatory signing, which shall retroactively apply.
In the event that Subrecipient is/was in receipt of SLFRF funding from CDHS prior to execution
of the instant Exhibit, Subrecipient understands that its obligations set forth herein with regards to
that funding shall retroactively apply.
The regulations and requirements surrounding receipt and use of SLFRF funding is an evolving
subject matter as established by the U.S. Department of Treasury and put into established policy
by the Colorado Department of Personnel & Administration, Office of the State Controller for use
with CDHS Agreements. As such, Subrecipient agrees to execute any additional
Agreements/Amendments as required by CDHS to establish and/or update these procedures.
Subrecipient agrees to accept written notice from CDHS of updates to these requirements and to
comply with same forthwith, even if prior to or without a formal Amendment to the Agreement to
Amendment Contract Number: 23 IBEH 177620 Page 1 of 28
Exhibit F-1
update this Exhibit or the rules/requirements established herein. Regardless, if CDHS requests that
Subrecipient execute an Amendment to formalize implementation of and/or acknowledgment of
updates to this Exhibit, Subrecipient shall promptly comply.
Subrecipient agrees to stay abreast of and comply with the most current iterations of the
requirements re SLFRF funding set forth on https://osc.colorado.gov/american-rescue-plan-act
(see SLFRF Grant Agreement Templates Tab).
APPENDIX 1 TO SLFRF EXHIBIT- BUDGET SUPPLEMENT
1. BUDGET BY US TREASURY EXPENDITURE CATEGORY
1.1 Expenditure Categories identified in this Appendix will determine what is reported on as
outlined in the following Appendices to this Exhibit.
Project
Number
Project Title
US Treasury Expenditure Category
Number and Name
Budget
PHI120
County -based Behavioral
Health Grant Program
1.14 Other Public Health Services
$680,165.00
Total
$680,165.00
2. BUDGET BY FUNCTION
3. EXPENDITURE CATEGORY MODIFICATIONS
1.1 Increases or decreases in any Expenditure Category must be requested and approved by the
State Agency by using the SLFRF Expenditure Modification Form. This form can be found
at: https://osc.colorado.gov/american-rescue-plan-act (see SLFRF Grant Agreement
Templates Tab). In no event may this be used to modify the overall total of this Agreement
or otherwise any non SLFRF expenditures.
APPENDIX 2 TO SLFRF EXHIBIT- FEDERAL PROVISIONS
SUPPLEMENT
1. APPLICABILITY OF PROVISIONS.
1.1. The Grant to which these Federal Provisions are attached has been funded, in whole or in
part, with an Award of Federal funds. In the event of a conflict between the provisions of
these Federal Provisions, the Special Provisions, the body of the Grant, or any attachments
or exhibits incorporated into and made a part of the Grant, the provisions of these Federal
Provisions shall control.
Amendment Contract Number: 23 IBEH 177620 Page 2 of 28
Exhibit F-1
1.2. The State of Colorado is accountable to Treasury for oversight of their subrecipients,
including ensuring their subrecipients comply with the SLFRF statute, SLFRF Award
Terms and Conditions, Treasury's Final Rule, and reporting requirements, as applicable.
1.3. Additionally, any subrecipient that issues a subaward to another entity (2"d tier
subrecipient), must hold the 2"d tier subrecipient accountable to these provisions and
adhere to reporting requirements.
1.4. These Federal Provisions are subject to the Award as defined in §2 of these Federal
Provisions, as may be revised pursuant to ongoing guidance from the relevant Federal or
State of Colorado agency or institutions of higher education.
2. DEFINITIONS.
2.1. For the purposes of these Federal Provisions, the following terms shall have the
meanings ascribed to them below.
2.1.1. "Award" means an award of Federal financial assistance, and the Grant
setting forth the terms and conditions of that financial assistance, that a non -Federal
Entity receives or administers.
2.1.2. "Entity" means:
2.1.2.1. a Non -Federal Entity;
2.1.2.2. a foreign public entity;
2.1.2.3. a foreign organization;
2.1.2.4. a non-profit organization;
2.1.2.5. a domestic for-profit organization (for 2 CFR parts 25 and 170 only);
2.1.2.6. a foreign non-profit organization (only for 2 CFR part 170) only);
2.1.2.7. a Federal agency, but only as a Subrecipient under an Award or Subaward
to a non -Federal entity (or 2 CFR 200.1); or
2.1.2.8. a foreign for-profit organization (for 2 CFR part 170 only).
2.1.3. "Executive" means an officer, managing partner or any other employee in
a management position.
2.1.4. "Expenditure Category (EC)" means the category of eligible uses as defined
by the US Department of Treasury in "Appendix 1 of the Compliance and
Reporting Guidance, State and Local Fiscal Recovery Funds" report
available at www.treasury.gov.
2.1.5. "Federal Awarding Agency" means a Federal agency providing a Federal
Award to a Recipient as described in 2 CFR 200.1
2.1.6. "Grant" means the Grant to which these Federal Provisions are attached.
2.1.7. "Grantee" means the party or parties identified as such in the Grant to which
these Federal Provisions are attached.
Amendment Contract Number: 23 IBEH 177620 Page 3 of 28
Exhibit F-1
2.1.8. "Non -Federal Entity means a State, local government, Indian tribe,
institution of higher education, or nonprofit organization that carries out a
Federal Award as a Recipient or a Subrecipient.
2.1.9. "Nonprofit Organization" means any corporation, trust, association,
cooperative, or other organization, not including IHEs, that:
2.1.9.1. Is operated primarily for scientific, educational, service, charitable, or
similar purposes in the public interest;
2.1.9.2. Is not organized primarily for profit; and
2.1.9.3. Uses net proceeds to maintain, improve, or expand the operations of the
organization.
2.1.10. "OMB" means the Executive Office of the President, Office of
Management and Budget.
2.1.11. "Pass -through Entity" means a non -Federal Entity that provides a Subaward
to a Subrecipient to carry out part of a Federal program.
2.1.12. "Prime Recipient" means the Colorado State agency or institution of higher
education identified as the Grantor in the Grant to which these Federal
Provisions are attached.
2.1.13. "Subaward" means an award by a Prime Recipient to a Subrecipient funded
in whole or in part by a Federal Award. The terms and conditions of the
Federal Award flow down to the Subaward unless the terms and conditions
of the Federal Award specifically indicate otherwise in accordance with 2
CFR 200.101. The term does not include payments to a Contractor or
payments to an individual that is a beneficiary of a Federal program.
2.1.14. "Subrecipient" or "Subgrantee" means a non -Federal Entity (or a Federal
agency under an Award or Subaward to a non -Federal Entity) receiving
Federal funds through a Prime Recipient to support the performance of the
Federal project or program for which the Federal funds were awarded. A
Subrecipient is subject to the terms and conditions of the Federal Award to
the Prime Recipient, including program compliance requirements. The term
does not include an individual who is a beneficiary of a federal program.
2.1.15. "System for Award Management (SAM)" means the Federal repository into
which an Entity must enter the information required under the Transparency
Act, which may be found at http://www.sam.gov. "Total Compensation"
means the cash and noncash dollar value earned by an Executive during the
Prime Recipient's or Subrecipient's preceding fiscal year (see 48 CFR
52.204-10, as prescribed in 48 CFR 4.1403(a)) and includes the following:
2.1.15.1. Salary and bonus;
2.1.15.2. Awards of stock, stock options, and stock appreciation rights, using the
dollar amount recognized for financial statement reporting purposes with
respect to the fiscal year in accordance with the Statement of Financial
Amendment Contract Number: 23 IBEH 177620 Page 4 of 28
Exhibit F-1
Accounting Standards No. 123 (Revised 2005) (FAS 123R), Shared Based
Payments;
2.1.15.3. Earnings for services under non -equity incentive plans, not including group
life, health, hospitalization or medical reimbursement plans that do not
discriminate in favor of Executives and are available generally to all salaried
employees;
2.1.15.4. Change in present value of defined benefit and actuarial pension plans;
2.1.15.5. Above -market earnings on deferred compensation which is not tax -
qualified;
2.1.15.6. Other compensation, if the aggregate value of all such other compensation
(e.g., severance, termination payments, value of life insurance paid on
behalf of the employee, perquisites, or property) for the Executive exceeds
$10,000.
2.1.16. "Transparency Act" means the Federal Funding Accountability and
Transparency Act of 2006 (Public Law 109-282), as amended by §6202 of
Public Law 110-252.
2.1.17. "Uniform Guidance" means the Office of Management and Budget Uniform
Administrative Requirements, Cost Principles, and Audit Requirements for
Federal Awards. The terms and conditions of the Uniform Guidance flow
down to Awards to Subrecipients unless the Uniform Guidance or the terms
and conditions of the Federal Award specifically indicate otherwise.
2.1.18. "Unique Entity ID" means the Unique Entity ID established by the federal
government for a Grantee at https://sam.gov/content/home.
3. COMPLIANCE.
3.1. Grantee shall comply with all applicable provisions of the Transparency Act and the
regulations issued pursuant thereto, all applicable provisions of the Uniform Guidance,
and all applicable Federal Laws and regulations required by this Federal Award. Any
revisions to such provisions or regulations shall automatically become a part of these
Federal Provisions, without the necessity of either party executing any further
instrument. The State of Colorado, at its discretion, may provide written notification to
Grantee of such revisions, but such notice shall not be a condition precedent to the
effectiveness of such revisions.
3.2. Per US Treasury Final Award requirements, grantee programs or services must not
include terms or conditions that undermine efforts to stop COVID-19 or discourage
compliance with recommendations and CDC guidelines.
Amendment Contract Number: 23 IBEH 177620 Page 5 of 28
Exhibit F-1
4. SYSTEM FOR AWARD MANAGEMENT (SAM) AND UNIQUE ENTITY ID SYSTEM (UEI)
REQUIREMENTS.
4.1. SAM. Grantee shall maintain the currency of its information in SAM until the Grantee
submits the final financial report required under the Award or receives final payment,
whichever is later. Grantee shall review and update SAM information at least annually
after the initial registration, and more frequently if required by changes in its
information.
4.2. UEI. Grantee shall provide its Unique Entity ID to its Prime Recipient and shall update
Grantee's information in SAM.gov at least annually after the initial registration, and
more frequently if required by changes in Grantee's information.
5. TOTAL COMPENSATION.
5.1. Grantee shall include Total Compensation in SAM for each of its five most highly
compensated Executives for the preceding fiscal year if:
5.1.1. The total Federal funding authorized to date under the Award is $30,000 or
more; and
5.1.2. In the preceding fiscal year, Grantee received:
5.1.2.1. 80% or more of its annual gross revenues from Federal procurement
Agreements and Subcontractors and/or Federal financial assistance Awards
or Subawards subject to the Transparency Act; and
5.1.2.2. $30,000,000 or more in annual gross revenues from Federal procurement
Agreements and Subcontractors and/or Federal financial assistance Awards
or Subawards subject to the Transparency Act; and
5.1.2.3. 5.1.2.3 The public does not have access to information about the
compensation of such Executives through periodic reports filed under
section 13(a) or 15(d) of the Securities Exchange Act of 1934 (15 U.S.C.
78m(a), 78o(d) or § 6104 of the Internal Revenue Code of 1986.
6. REPORTING.
6.1. If Grantee is a Subrecipient of the Award pursuant to the Transparency Act, Grantee
shall report data elements to SAM and to the Prime Recipient as required in this Exhibit.
No direct payment shall be made to Grantee for providing any reports required under
these Federal Provisions and the cost of producing such reports shall be included in the
Grant price. The reporting requirements in this Exhibit are based on guidance from the
OMB, and as such are subject to change at any time by OMB. Any such changes shall
be automatically incorporated into this Grant and shall become part of Grantee's
obligations under this Grant.
Amendment Contract Number: 23 IBEH 177620 Page 6 of 28
Exhibit F-1
7. EFFECTIVE DATE AND DOLLAR THRESHOLD FOR FEDERAL REPORTING.
7.1. Reporting requirements in §8 below apply to new Awards as of October 1, 2010, if the
initial award is $30,000 or more. If the initial Award is below $30,000 but subsequent
Award modifications result in a total Award of $30,000 or more, the Award is subject
to the reporting requirements as of the date the Award exceeds $30,000. If the initial
Award is $30,000 or more, but funding is subsequently de -obligated such that the total
award amount falls below $30,000, the Award shall continue to be subject to the
reporting requirements. If the total award is below $30,000 no reporting required; if
more than $30,000 and less than $50,000 then FFATA reporting is required; and,
$50,000 and above SLFRF reporting is required.
7.2. The procurement standards in §9 below are applicable to new Awards made by Prime
Recipient as of December 26, 2015. The standards set forth in §11 below are applicable
to audits of fiscal years beginning on or after December 26, 2014.
8. SUBRECIPIENT REPORTING REQUIREMENTS.
8.1. Grantee shall report as set forth below.
8.1.1. Grantee shall use the SLFRF Subrecipient Quarterly Report Workbook as referenced
in Appendix 4 to report to the State Agency within ten (10) days following each quarter
ended September, December, March, and June. Additional information on specific
requirements are detailed in the SLFRF Subrecipient Quarterly Report Workbooks and
"Compliance and Reporting Guidance, State and Local Fiscal Recovery Funds" report
available at www.treasury.gov.
EC 1— Public Health
All Public Health Projects
a) Description of structure and objectives
b) Description of relation to COVID-19
c) Identification of impacted and/or disproportionately impacted communities
d) Capital Expenditures
i. Presence of capital expenditure in project
ii. Total projected capital expenditure
iii. Type of capital expenditure
iv. Written justification
v. Labor reporting
COVID-19 Interventions and Mental Health (1.4, 1.11, 1.12, 1.13)
a) Amount of total project used for evidence -based programs
b) Evaluation plan description
COVID-19 Small Business Economic Assistance (1.8)
a) Number of small businesses served
COVID-19 Assistance to Non -Profits (1.9)
a) Number of non -profits served
COVID-19 Aid to Travel, Tourism, and Hospitality or Other Impacted Industries (1.10)
a) Sector of employer
b) Purpose of funds
Amendment Contract Number: 23 IBEH 177620 Page 7 of 28
Exhibit F-1
EC 2 — Negative Economic Impacts
All Negative Economic Impacts Projects
a) Description of project structure and objectives
b) Description of project's response to COVID-19
c) Identification of impacted and/or disproportionately impacted communities
d) Amount of total project used for evidence -based programs and description of
evaluation plan (not required for 2.5, 2.8, 2.21-2.24, 2.27-2.29, 2.31, 2.34-2.36)
e) Number of workers enrolled in sectoral job training programs
f) Number of workers completing sectoral job training programs
g) Number of people participating in summer youth employment programs
h) Capital Expenditures
i. Presence of capital expenditure in project
ii. Total projected capital expenditure
iii. Type of capital expenditure
iv. Written justification
v. Labor reporting
Household Assistance (2.1-2.8)
a) Number of households served
b) Number of people or households receiving eviction prevention services (2.2 & 2.5
only) (Federal guidance may change this requirement in July 2022)
c) Number of affordable housing units preserved or developed (2.2 & 2.5 only)
(Federal guidance may change this requirement in July 2022)
Healthy Childhood Environments (2.11-2.13)
a) Number of children served by childcare and early learning (Federal guidance may
change this requirement in July 2022)
b) Number of families served by home visiting (Federal guidance may change this
requirement in July 2022)
Education Assistance (2.14, 2.24-2.27)
a) National Center for Education Statistics ("NCES") School ID or NCES District ID
b) Number of students participating in evidence -based programs (Federal guidance may
change this requirement in July 2022)
Housing Support (2.15, 2.16, 2.18)
a) Number of people or households receiving eviction prevention services (Federal
guidance may change this requirement in July 2022)
b) Number of affordable housing units preserved or developed (Federal guidance may
change this requirement in July 2022)
Small Business Economic Assistance (2.29-2.33)
a) Number of small businesses served
Assistance to Non -Profits (234)
a) Number of non -profits served
Aid to Travel, Tourism, and Hospitality or Other Impacted Industries (2.35-236)
a) Sector of employer
b) Purpose of funds
c) If other than travel, tourism and hospitality (2.36) — description of hardship
Amendment Contract Number: 23 IBEH 177620 Page 8 of 28
Exhibit F-1
EC 3 — Public Health — Negative Economic Impact: Public Sector Capacity
Payroll for Public Health and Safety Employees (EC 3.1)
a) Number of government FTEs responding to COVID-19
Rehiring Public Sector Staff (EC 3.2)
a) Number of FTEs rehired by governments
EC 4 — Premium Pay
All Premium Pay Projects
a) List of sectors designated as critical by the chief executive of the jurisdiction, if
beyond those listed in the final rule
b) Numbers of workers served
c) Employer sector for all subawards to third -party employers
d) Written narrative justification of how premium pay is responsive to essential work
during the public health emergency for non-exempt workers or those making over
150 percent of the state/county's average annual wage
e) Number of workers to be served with premium pay in K-12 schools
EC 5 — Infrastructure Projects
All Infrastructure Projects
a) Projected/actual construction start date (month/year)
b) Projected/actual initiation of operations date (month/year)
c) Location (for broadband, geospatial data of locations to be served)
d) Projects over $10 million
i. Prevailing wage certification or detailed project employment and local
impact report
ii. Project labor agreement certification or project workforce continuity
plan
iii. Prioritization of local hires
iv. Community benefit agreement description, if applicable
Water and sewer projects (EC 5.1-5.18)
a) National Pollutant Discharge Elimination System (NPDES) Permit Number (if
applicable; for projects aligned with the Clean Water State Revolving Fund)
b) Public Water System (PWS) ID number (if applicable; for projects aligned with
the Drinking Water State Revolving Fund)
c) Median Household Income of service area
d) Lowest Quintile Income of the service area
Broadband projects (EC 5.19-5.21)
a) Confirm that the project is designed to, upon completion, reliably meet or exceed
symmetrical 100 Mbps download and upload speeds.
i. If the project is not designed to reliably meet or exceed symmetrical 100
Mbps download and upload speeds, explain why not, and
ii. Confirm that the project is designed to, upon completion, meet or exceed
100 Mbps download speed and between at least 20 Mbps and 100 Mbps
upload speed, and be scalable to a minimum of 100 Mbps download
speed and 100 Mbps upload speed.
Amendment Contract Number: 23 IBEH 177620 Page 9 of 28
Exhibit F-1
b) Additional programmatic data will be required for broadband projects and will be
defined in a subsequent version of the US Treasury Reporting Guidance,
including, but not limited to (Federal guidance may change this requirement in July 2022):
i. Number of households (broken out by households on Tribal lands and
those not on Tribal lands) that have gained increased access to
broadband meeting the minimum speed standards in areas that
previously lacked access to service of at least 25 Mbps download and 3
Mbps upload, with the number of households with access to minimum
speed standard of reliable 100 Mbps symmetrical upload and download
and number of households with access to minimum speed standard of
reliable 100 Mbps download and 20 Mbps upload
ii. Number of institutions and businesses (broken out by institutions on
Tribal lands and those not on Tribal lands) that have projected increased
access to broadband meeting the minimum speed standards in areas that
previously lacked access to service of at least 25 Mbps download and 3
Mbps upload, in each of the following categories: business, small
business, elementary school, secondary school, higher education
institution, library, healthcare facility, and public safety organization,
with the number of each type of institution with access to the minimum
speed standard of reliable 100 Mbps symmetrical upload and download;
and number of each type of institution with access to the minimum
speed standard of reliable 100 Mbps download and 20 Mbps upload.
iii. Narrative identifying speeds/pricing tiers to be offered, including the
speed/pricing of its affordability offering, technology to be deployed,
miles of fiber, cost per mile, cost per passing, number of households
(broken out by households on Tribal lands and those not on Tribal lands)
projected to have increased access to broadband meeting the minimum
speed standards in areas that previously lacked access to service of at
least 25 Mbps download and 3 Mbps upload, number of households with
access to minimum speed standard of reliable 100 Mbps symmetrical
upload and download, number of households with access to minimum
speed standard of reliable 100 Mbps download and 20 Mbps upload, and
number of institutions and businesses (broken out by institutions on
Tribal lands and those not on Tribal lands) projected to have increased
access to broadband meeting the minimum speed standards in areas that
previously lacked access to service of at least 25 Mbps download and 3
Mbps upload, in each of the following categories: business, small
business, elementary school, secondary school, higher education
institution, library, healthcare facility, and public safety organization.
Specify the number of each type of institution with access to the
minimum speed standard of reliable 100 Mbps symmetrical upload and
download; and the number of each type of institution with access to the
minimum speed standard of reliable 100 Mbps download and 20 Mbps
upload.
Amendment Contract Number: 23 IBEH 177620 Page 10 of 28
Exhibit F-1
All Expenditure Categories
a) Program income earned and expended to cover eligible project costs
8.1.2. A Subrecipient shall report the following data elements to Prime Recipient no later
than five days after the end of the month following the month in which the Subaward
was made.
8.1.2.1. Subrecipient Unique Entity ID;
8.1.2.2. Subrecipient Unique Entity ID if more than one electronic funds transfer
(EFT) account;
8.1.2.3. Subrecipient parent's organization Unique Entity ID;
8.1.2.4. Subrecipient's address, including: Street Address, City, State, Country, Zip
+ 4, and Congressional District;
8.1.2.5. Subrecipient's top 5 most highly compensated Executives if the criteria in
§4 above are met; and
8.1.2.6. Subrecipient's Total Compensation of top 5 most highly compensated
Executives if the criteria in §4 above met.
8.1.3. To Prime Recipient. A Subrecipient shall report to its Prime Recipient, the
following data elements:
8.1.3.1. Subrecipient's Unique Entity ID as registered in SAM.
8.1.3.2. Primary Place of Performance Information, including: Street Address, City,
State, Country, Zip code + 4, and Congressional District.
8.1.3.3. Narrative identifying methodology for serving disadvantaged communities.
See the "Project Demographic Distribution" section in the "Compliance and
Reporting Guidance, State and Local Fiscal Recovery Funds" report
available at www.treasury.gov. This requirement is applicable to all
projects in Expenditure Categories 1 and 2.
8.1.3.4. Narrative identifying funds allocated towards evidenced -based
interventions and the evidence base. See the "Use of Evidence" section in
the "Compliance and Reporting Guidance, State and Local Fiscal Recovery
Funds" report available at www.treasury.gov. See section 8.1.1 for relevant
Expenditure Categories.
8.1.3.5. Narrative describing the structure and objectives of the assistance program
and in what manner the aid responds to the public health and negative
economic impacts of COVID-19. This requirement is applicable to
Expenditure Categories 1 and 2. For aid to travel, tourism, and hospitality
or other impacted industries (EC 2.11-2.12), also provide the sector of
employer, purpose of funds, and if not travel, tourism and hospitality a
description of the pandemic impact on the industry.
8.1.3.6. Narrative identifying the sector served and designated as critical to the
health and well-being of residents by the chief executive of the jurisdiction
and the number of workers expected to be served. For groups of workers
Amendment Contract Number: 23 IBEH 177620 Page 11 of 28
Exhibit F-1
(e.g., an operating unit, a classification of worker, etc.) or, to the extent
applicable, individual workers, other than those where the eligible worker
receiving premium pay is earning (with the premium pay included) below
150 percent of their residing state or county's average annual wage for all
occupations, as defined by the Bureau of Labor Statistics Occupational
Employment and Wage Statistics, whichever is higher, OR the eligible
worker receiving premium pay is not exempt from the Fair Labor Standards
Act overtime provisions, include justification of how the premium pay or
grant is responsive to workers performing essential work during the public
health emergency. This could include a description of the essential workers'
duties, health or financial risks faced due to COVID-19 but should not
include personally identifiable information. This requirement applies to EC
4.1, and 4.2.
8.1.3.7. For infrastructure projects (EC 5) or capital expenditures in any expenditure
category, narrative identifying the projected construction start date
(month/year), projected initiation of operations date (month/year), and
location (for broadband, geospatial location data).
8.1.3.7.1. For projects over $10 million:
8.1.3.7.1.1.
8.1.3.7.1.2.
Certification that all laborers and mechanics employed by
Contractors and Subcontractors in the performance of such
project are paid wages at rates not less than those prevailing,
as determined by the U.S. Secretary of Labor in accordance
with subchapter IV of chapter 31 of title 40, United States
Code (commonly known as the "Davis -Bacon Act"), for the
corresponding classes of laborers and mechanics employed on
projects of a character similar to the Agreement work in the
civil subdivision of the State (or the District of Columbia) in
which the work is to be performed, or by the appropriate State
entity pursuant to a corollary State prevailing -wage -in -
construction law (commonly known as "baby Davis -Bacon
Acts"). If such certification is not provided, a recipient must
provide a project employment and local impact report
detailing (1) the number of employees of Contractors and sub-
contractors working on the project; (2) the number of
employees on the project hired directly and hired through a
third party; (3) the wages and benefits of workers on the
project by classification; and (4) whether those wages are at
rates less than those prevailing. Recipients must maintain
sufficient records to substantiate this information upon
request.
A Subrecipient may provide a certification that a project
includes a project labor agreement, meaning a pre -hire
collective bargaining agreement consistent with section 8(f)
of the National Labor Relations Act (29 U.S.C. 158(f)). If the
recipient does not provide such certification, the recipient
Amendment Contract Number: 23 IBEH 177620 Page 12 of 28
Exhibit F-1
8.1.3.7.1.3.
8.1.3.7.1.4.
must provide a project workforce continuity plan, detailing:
(1) how the Subrecipient will ensure the project has ready
access to a sufficient supply of appropriately skilled and
unskilled labor to ensure high -quality construction throughout
the life of the project; (2) how the Subrecipient will minimize
risks of labor disputes and disruptions that would jeopardize
timeliness and cost-effectiveness of the project; and (3) how
the Subrecipient will provide a safe and healthy workplace
that avoids delays and costs associated with workplace
illnesses, injuries, and fatalities; (4) whether workers on the
project will receive wages and benefits that will secure an
appropriately skilled workforce in the context of the local or
regional labor market; and (5) whether the project has
completed a project labor agreement.
Whether the project prioritizes local hires.
Whether the project has a Community Benefit Agreement,
with a description of any such agreement.
8.1.4. Subrecipient also agrees to comply with any reporting requirements established by the
US Treasury, Governor's Office and Office of the State Controller. The State of
Colorado may need additional reporting requirements after this agreement is executed.
If there are additional reporting requirements, the State will provide notice of such
additional reporting requirements via Appendix 5— SLFRF Reporting Modification
Form.
9. PROCUREMENT STANDARDS.
9.1. Procurement Procedures. A Subrecipient shall use its own documented procurement
procedures which reflect applicable State, local, and Tribal laws and applicable
regulations, provided that the procurements conform to applicable Federal law and the
standards identified in the Uniform Guidance, including without limitation, 2 CFR
200.318 through 200.327 thereof.
9.2. Domestic preference for procurements (2 CFR 200.322). As appropriate and to the
extent consistent with law, the non -Federal entity should, to the greatest extent
practicable under a Federal award, provide a preference for the purchase, acquisition,
or use of goods, products, or materials produced in the United States (including but not
limited to iron, aluminum, steel, cement, and other manufactured products). The
requirements of this section must be included in all subawards including all
Agreements and purchase orders for work or products under this award.
Amendment Contract Number: 23 IBEH 177620 Page 13 of 28
Exhibit F-1
9.3. Procurement of Recovered Materials. If a Subrecipient is a State Agency or an agency
of a political subdivision of the State, its Contractors must comply with section 6002
of the Solid Waste Disposal Act, as amended by the Resource Conservation and
Recovery Act. The requirements of Section 6002 include procuring only items
designated in guidelines of the Environmental Protection Agency (EPA) at 40 CFR part
247, that contain the highest percentage of recovered materials practicable, consistent
with maintaining a satisfactory level of competition, where the purchase price of the
item exceeds $10,000 or the value of the quantity acquired during the preceding fiscal
year exceeded $10,000; procuring solid waste management services in a manner that
maximizes energy and resource recovery; and establishing an affirmative procurement
program for procurement of recovered materials identified in the EPA guidelines.
10. ACCESS TO RECORDS.
10.1. A Subrecipient shall permit Prime Recipient and its auditors to have access to
Subrecipient's records and financial statements as necessary for Recipient to meet the
requirements of 2 CFR 200.332 (Requirements for pass -through entities), 2 CFR
200.300 (Statutory and national policy requirements) through 2 CFR 200.309 (Period
of performance), and Subpart F -Audit Requirements of the Uniform Guidance.
11. SINGLE AUDIT REQUIREMENTS.
11.1. If a Subrecipient expends $750,000 or more in Federal Awards during the
Subrecipient's fiscal year, the Subrecipient shall procure or arrange for a single or
program -specific audit conducted for that year in accordance with the provisions of
Subpart F -Audit Requirements of the Uniform Guidance, issued pursuant to the Single
Audit Act Amendments of 1996, (31 U.S.C. 7501-7507). 2 CFR 200.501.
11.1.1. Election. A Subrecipient shall have a single audit conducted in accordance
with Uniform Guidance 2 CFR 200.514 (Scope of audit), except when it elects to
have a program -specific audit conducted in accordance with 2 CFR 200.507
(Program -specific audits). The Subrecipient may elect to have a program -specific
audit if Subrecipient expends Federal Awards under only one Federal program
(excluding research and development) and the Federal program's statutes,
regulations, or the terms and conditions of the Federal award do not require a
financial statement audit of Prime Recipient. A program -specific audit may not be
elected for research and development unless all of the Federal Awards expended
were received from Recipient and Recipient approves in advance a program -
specific audit.
11.1.2. Exemption. If a Subrecipient expends less than $750,000 in Federal Awards
during its fiscal year, the Subrecipient shall be exempt from Federal audit
requirements for that year, except as noted in 2 CFR 200.503 (Relation to other
audit requirements), but records shall be available for review or audit by appropriate
officials of the Federal agency, the State, and the Government Accountability
Office.
Amendment Contract Number: 23 IBEH 177620 Page 14 of 28
Exhibit F-1
11.1.3. Subrecipient Compliance Responsibility. A Subrecipient shall procure or
otherwise arrange for the audit required by Subpart F of the Uniform Guidance and
ensure it is properly performed and submitted when due in accordance with the
Uniform Guidance. Subrecipient shall prepare appropriate financial statements,
including the schedule of expenditures of Federal awards in accordance with 2 CFR
200.510 (Financial statements) and provide the auditor with access to personnel,
accounts, books, records, supporting documentation, and other information as
needed for the auditor to perform the audit required by Uniform Guidance Subpart
F -Audit Requirements.
12. GRANT PROVISIONS FOR SUBRECIPIENT AGREEMENTS.
12.1. In addition to other provisions required by the Federal Awarding Agency or the Prime
Recipient, Grantees that are Subrecipients shall comply with the following provisions.
Subrecipients shall include all of the following applicable provisions in all
Subcontractors entered into by it pursuant to this Grant.
12.1.1. [Applicable to federally assisted construction Agreements.] Equal
Employment Opportunity. Except as otherwise provided under 41 CFR Part 60, all
Agreements that meet the definition of "federally assisted construction Agreement"
in 41 CFR Part 60-1.3 shall include the equal opportunity clause provided under 41
CFR 60-1.4(b), in accordance with Executive Order 11246, "Equal Employment
Opportunity" (30 FR 12319, 12935, 3 CFR Part, 1964-1965 Comp., p. 339), as
amended by Executive Order 11375, "Amending Executive Order 11246 Relating
to Equal Employment Opportunity," and implementing regulations at 41 CFR part
60, Office of Federal Agreement Compliance Programs, Equal Employment
Opportunity, Department of Labor.
12.1.2. [Applicable to on -site employees working on government -funded
construction, alteration and repair projects.] Davis -Bacon Act. Davis -Bacon Act,
as amended (40 U.S.C. 3141-3148).
12.1.3. Rights to Inventions Made Under a grant or agreement. If the Federal
Award meets the definition of "funding agreement" under 37 CFR 401.2 (a) and
the Prime Recipient or Subrecipient wishes to enter into an Agreement with a small
business firm or nonprofit organization regarding the substitution of parties,
assignment or performance of experimental, developmental, or research work
under that "funding agreement," the Prime Recipient or Subrecipient must comply
with the requirements of 37 CFR Part 401, "Rights to Inventions Made by
Nonprofit Organizations and Small Business Firms Under Government Grants,
Agreements and Cooperative Agreements," and any implementing regulations
issued by the Federal Awarding Agency.
Amendment Contract Number: 23 IBEH 177620 Page 15 of 28
Exhibit F-1
12.1.4. Clean Air Act (42 U.S.C. 7401-7671q.) and the Federal Water Pollution
Control Act (33 U.S.C. 1251-1387), as amended. Agreements and subgrants of
amounts in excess of $150,000 must contain a provision that requires the non -
Federal awardees to agree to comply with all applicable standards, orders or
regulations issued pursuant to the Clean Air Act (42 U.S.C. 7401-7671q) and the
Federal Water Pollution Control Act as amended (33 U.S.C. 1251-1387).
Violations must be reported to the Federal Awarding Agency and the Regional
Office of the Environmental Protection Agency (EPA).
12.1.5. Debarment and Suspension (Executive Orders 12549 and 12689). A
Agreement award (see 2 CFR 180.220) must not be made to parties listed on the
government wide exclusions in SAM, in accordance with the OMB guidelines at 2
CFR 180 that implement Executive Orders 12549 (3 CFR part 1986 Comp., p. 189)
and 12689 (3 CFR part 1989 Comp., p. 235), "Debarment and Suspension." SAM
Exclusions contains the names of parties debarred, suspended, or otherwise
excluded by agencies, as well as parties declared ineligible under statutory or
regulatory authority other than Executive Order 12549.
12.1.6. Byrd Anti -Lobbying Amendment (31 U.S.C. 1352). Contractors that apply
or bid for an award exceeding $100,000 must file the required certification. Each
tier certifies to the tier above that it will not and has not used Federal appropriated
funds to pay any person or organization for influencing or attempting to influence
an officer or employee of any agency, a member of Congress, officer or employee
of Congress, or an employee of a member of Congress in connection with obtaining
any Federal Agreement, grant or any other award covered by 31 U.S.C. 1352. Each
tier must also disclose any lobbying with non -Federal funds that takes place in
connection with obtaining any Federal award. Such disclosures are forwarded from
tier to tier up to the non -Federal award.
12.1.7. Never Agreement with the enemy (2 CFR 200.215). Federal awarding
agencies and recipients are subject to the regulations implementing "Never
Agreement with the enemy" in 2 CFR part 183. The regulations in 2 CFR part 183
affect covered Agreements, grants and cooperative agreements that are expected to
exceed $50,000 within the period of performance, are performed outside the United
States and its territories, and are in support of a contingency operation in which
members of the Armed Forces are actively engaged in hostilities.
12.1.8. Prohibition on certain telecommunications and video surveillance services
or equipment (2 CFR 200.216). Grantee is prohibited from obligating or expending
loan or grant funds on certain telecommunications and video surveillance services
or equipment pursuant to 2 CFR 200.216.
Amendment Contract Number: 23 IBEH 177620 Page 16 of 28
Exhibit F-1
12.1.9. Title VI of the Civil Rights Act. The Subgrantee, Contractor, Subcontractor,
transferee, and assignee shall comply with Title VI of the Civil Rights Act of 1964,
which prohibits recipients of federal financial assistance from excluding from a
program or activity, denying benefits of, or otherwise discriminating against a
person on the basis of race, color, or national origin (42 U.S.C. § 2000d et seq.), as
implemented by the Department of Treasury's Title VI regulations, 31 CFR Part
22, which are herein incorporated by reference and made a part of this Agreement
(or agreement). Title VI also includes protection to persons with "Limited English
Proficiency" in any program or activity receiving federal financial assistance, 42
U.S. C. § 2000d et seq., as implemented by the Department of the Treasury's Title
VI regulations, 31 CRF Part 22, and herein incorporated by reference and made part
of this Agreement or agreement.
13. CERTIFICATIONS.
13.1. Subrecipient Certification. Subrecipient shall sign a "State of Colorado Agreement
with Recipient of Federal Recovery Funds" Certification Form in separate Appendix
hereto and submit to State Agency with signed grant agreement.
13.2. Unless prohibited by Federal statutes or regulations, Prime Recipient may require
Subrecipient to submit certifications and representations required by Federal statutes
or regulations on an annual basis. 2 CFR 200.208. Submission may be required more
frequently if Subrecipient fails to meet a requirement of the Federal award.
Subrecipient shall certify in writing to the State at the end of the Award that the project
or activity was completed, or the level of effort was expended. 2 CFR 200.201(3). If
the required level of activity or effort was not carried out, the amount of the Award
must be adjusted.
14. EXEMPTIONS.
14.1. These Federal Provisions do not apply to an individual who receives an Award as a
natural person, unrelated to any business or non-profit organization he or she may own
or operate in his or her name.
14.2. A Grantee with gross income from all sources of less than $300,000 in the previous tax
year is exempt from the requirements to report Subawards and the Total Compensation
of its most highly compensated Executives.
15. EVENT OF DEFAULT AND TERMINATION.
15.1. Failure to comply with these Federal Provisions shall constitute an event of default
under the Grant and the State of Colorado may terminate the Grant upon 30 days prior
written notice if the default remains uncured five calendar days following the
termination of the 30 -day notice period. This remedy will be in addition to any other
remedy available to the State of Colorado under the Grant, at law or in equity.
15.2. Termination (2 CFR 200.340). The Federal Award may be terminated in whole or in
part as follows:
15.2.1. By the Federal Awarding Agency or Pass -through Entity, if a Non -Federal
Entity fails to comply with the terms and conditions of a Federal Award;
Amendment Contract Number: 23 IBEH 177620 Page 17 of 28
Exhibit F-1
15.2.2. By the Federal awarding agency or Pass -through Entity, to the greatest
extent authorized by law, if an award no longer effectuates the program
goals or agency priorities;
15.2.3. By the Federal awarding agency or Pass -through Entity with the consent of
the Non -Federal Entity, in which case the two parties must agree upon the
termination conditions, including the effective date and, in the case of
partial termination, the portion to be terminated;
15.2.4. By the Non -Federal Entity upon sending to the Federal Awarding Agency
or Pass -through Entity written notification setting forth the reasons for such
termination, the effective date, and, in the case of partial termination, the
portion to be terminated. However, if the Federal Awarding Agency or Pass -
through Entity determines in the case of partial termination that the reduced
or modified portion of the Federal Award or Subaward will not accomplish
the purposes for which the Federal Award was made, the Federal Awarding
Agency or Pass -through Entity may terminate the Federal Award in its
entirety; or
15.2.5. By the Federal Awarding Agency or Pass -through Entity pursuant to
termination provisions included in the Federal Award.
[THE REST OF THIS PAGE IS INTENTIONALLY LEFT BLANK]
Amendment Contract Number: 23 IBEH 177620 Page 18 of 28
Exhibit F-1
APPENDIX 3 TO SLFRF EXHIBIT- SUBRECIPIENT CERTIFICATION
AGREEMENT
AGREEMENT WITH SUBRECIPIENT OF FEDERAL RECOVERY FUNDS
Section 602(b) of the Social Security Act (the Act), as added by section 9901 of the
American Rescue Plan Act (ARPA), Pub. L. No. 117-2 (March 11, 2021), authorizes the
Department of the Treasury (Treasury) to make payments to certain Subrecipients from
the Coronavirus State Fiscal Recovery Fund. The State of Colorado has signed and
certified a separate agreement with Treasury as a condition of receiving such payments
from the Treasury. This agreement is between your organization and the State and your
organization is signing and certifying the same terms and conditions included in the
State's separate agreement with Treasury. Your organization is referred to as a
Subrecipient.
As a condition of your organization receiving federal recovery funds from the State, the
authorized representative below hereby (i) certifies that your organization will carry out
the activities listed in section 602(c) of the Act and (ii) agrees to the terms attached hereto.
Your organization also agrees to use the federal recovery funds as specified in bills passed
by the General Assembly and signed by the Governor.
Under penalty of perjury, the undersigned official certifies that the authorized
representative has read and understood the organization's obligations in the Assurances
of Compliance and Civil Rights Requirements, that any information submitted in
conjunction with this assurances document is accurate and complete, and that the
organization is in compliance with the nondiscrimination requirements.
Subrecipient Name:
Authorized Representative:
Title:
Signature:
Amendment Contract Number: 23 IBEH 177620 Page 19 of 28
Exhibit F-1
AGREEMENT WITH SUBRECIPIENT OF FEDERAL RECOVERY FUNDS
TERMS AND CONDITIONS
1. Use of Funds.
a. Subrecipient understands and agrees that the funds disbursed under this award
may only be used in compliance with section 602(c) of the Social Security Act
(the Act) and Treasury's regulations implementing that section and guidance.
b. Subrecipient will determine prior to engaging in any project using this assistance
that it has the institutional, managerial, and financial capability to ensure proper
planning, management, and completion of such project.
2. Period of Performance. The period of performance for this subaward is shown on
page one of this Agreement. Subrecipient may use funds to cover eligible costs
incurred, as set forth in Treasury's implementing regulations, during this period of
performance.
3. Reporting. Subrecipient agrees to comply with any reporting obligations established by
Treasury as they relate to this award. Subrecipient also agrees to comply with any reporting
requirements established by the Governor's Office and Office of the State Controller. The
State will provide notice of such additional reporting requirements via separate Appendix
hereto — Reporting Modification Form.
4. Maintenance of and Access to Records
a. Subrecipient shall maintain records and financial documents sufficient to
evidence compliance with section 602(c), Treasury's regulations implementing
that section, and guidance issued by Treasury regarding the foregoing.
b. The Treasury Office of Inspector General and the Government Accountability
Office, or their authorized representatives, shall have the right of access to records
(electronic and otherwise) of Subrecipient in order to conduct audits or other
investigations.
c. Records shall be maintained by Subrecipient for a period of five (5) years after
all funds have been expended or returned to Treasury, whichever is later.
5. Pre -award Costs. Pre -award costs, as defined in 2 C.F.R. § 200.458, may not be paid
with funding from this award.
6. Administrative Costs. Subrecipient may use funds provided under this award to cover
both direct and indirect costs. Subrecipient shall follow guidance on administrative
costs issued by the Governor's Office and Office of the State Controller.
Amendment Contract Number: 23 IBEH 177620 Page 20 of 28
Exhibit F-1
7. Cost Sharing. Cost sharing or matching funds are not required to be provided by
Subrecipient.
8. Conflicts of Interest. The State of Colorado understands and agrees it must maintain a
conflict -of -interest policy consistent with 2 C.F.R. § 200.318(c) and that such conflict -of -
interest policy is applicable to each activity funded under this award. Subrecipient and
Contractors must disclose in writing to the Office of the State Controller or the pass -
through entity, as appropriate, any potential conflict of interest affecting the awarded
funds in accordance with 2 C.F.R. § 200.112. The Office of the State Controller shall
disclose such conflict to Treasury.
9. Compliance with Applicable Law and Regulations.
a. Subrecipient agrees to comply with the requirements of section 602 of the Act,
regulations adopted by Treasury pursuant to section 602(f) of the Act, and
guidance issued by Treasury regarding the foregoing. Subrecipient also agrees to
comply with all other applicable federal statutes, regulations, and executive
orders, and Subrecipient shall provide for such compliance by other parties in any
agreements it enters into with other parties relating to this award.
b. Federal regulations applicable to this award include, without limitation, the following:
i. Uniform Administrative Requirements, Cost Principles, and Audit
Requirements for Federal Awards, 2 C.F.R. Part 200, other than such
provisions as Treasury may determine are inapplicable to this Award and
subject to such exceptions as may be otherwise provided by Treasury.
Subpart F — Audit Requirements of the Uniform Guidance, implementing
the Single Audit Act, shall apply to this award.
ii. Universal Identifier and System for Award Management (SAM), 2 C.F.R.
Part 25, pursuant to which the award term set forth in Appendix A to 2
C.F.R. Part 25 is hereby incorporated by reference.
iii. Reporting Subaward and Executive Compensation Information, 2 C.F.R.
Part 170, pursuant to which the award term set forth in Appendix A to 2
C.F.R. Part 170 is hereby incorporated by reference.
iv. OMB Guidelines to Agencies on Government wide Debarment and
Suspension (Nonprocurement), 2 C.F.R. Part 180, including the
requirement to include a term or condition in all lower tier covered
transactions (Agreements and Subcontractors described in 2 C.F.R. Part
180, subpart B) that the award is subject to 2 C.F.R. Part 180 and
Treasury's implementing regulation at 31 C.F.R. Part 19.
v. Subrecipient Integrity and Performance Matters, pursuant to which the
award term set forth in 2 C.F.R. Part 200, Appendix XII to Part 200 is
hereby incorporated by reference.
Amendment Contract Number: 23 IBEH 177620 Page 21 of 28
Exhibit F-1
vi. Government wide Requirements for Drug -Free Workplace, 31 C.F.R. Part
20.
vii. New Restrictions on Lobbying, 31 C.F.R. Part 21.
viii. Uniform Relocation Assistance and Real Property Acquisitions Act of
1970 (42 U.S.C. §§ 4601-4655) and implementing regulations.
ix. Generally applicable federal environmental laws and regulations.
c. Statutes and regulations prohibiting discrimination applicable to this award
include, without limitation, the following:
i. Title VI of the Civil Rights Act of 1964 (42 U.S.C. §§ 2000d et seq.) and
Treasury's implementing regulations at 31 C.F.R. Part 22, which prohibit
discrimination on the basis of race, color, or national origin under
programs or activities receiving federal financial assistance;
ii. The Fair Housing Act, Title VIII of the Civil Rights Act of 1968 (42
U.S.C. §§ 3601 et seq.), which prohibits discrimination in housing on
the basis of race, color, religion, national origin, sex, familial status, or
disability;
iii. Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. §
794), which prohibits discrimination on the basis of disability under any
program or activity receiving federal financial assistance;
iv. The Age Discrimination Act of 1975, as amended (42 U.S.C. §§ 6101 et
seq.), and Treasury's implementing regulations at 31 C.F.R. Part 23,
which prohibit discrimination on the basis of age in programs or activities
receiving federal financial assistance; and
v. Title II of the Americans with Disabilities Act of 1990, as amended (42
U.S.C. §§ 12101 et seq.), which prohibits discrimination on the basis of
disability under programs, activities, and services provided or made
available by state and local governments or instrumentalities or agencies
thereto.
Amendment Contract Number: 23 IBEH 177620 Page 22 of 28
Exhibit F-1
10. Remedial Actions. In the event of Subrecipient's noncompliance with section 602 of
the Act, other applicable laws, Treasury's implementing regulations, guidance, or any
reporting or other program requirements, Treasury may impose additional conditions
on the receipt of a subsequent tranche of future award funds, if any, or take other
available remedies as set forth in 2 C.F.R. § 200.339. In the case of a violation of
section 602(c) of the Act regarding the use of funds, previous payments shall be
subject to recoupment as provided in section 602(e) of the Act and any additional
payments may be subject to withholding as provided in sections 602(b)(6)(A)(ii)(III)
of the Act, as applicable.
11. Hatch Act. Subrecipient agrees to comply, as applicable, with requirements of the
Hatch Act (5 U.S.C.§§ 1501-1508 and 7324-7328), which limit certain political
activities of State or local government employees whose principal employment is in
connection with an activity financed in whole or in part by this federal assistance.
12. False Statements. Subrecipient understands that making false statements or claims in
connection with this award is a violation of federal law and may result in criminal,
civil, or administrative sanctions, including fines, imprisonment, civil damages and
penalties, debarment from participating in federal awards or Agreements, and/or any
other remedy available by law.
13. Publications. Any publications produced with funds from this award must display the
following language: "This project [is being] [was] supported, in whole or in part, by
federal award number SLFRF0126 awarded to the State of Colorado by the U.S.
Department of the Treasury."
14. Debts Owed the Federal Government.
a. Any funds paid to the Subrecipient (1) in excess of the amount to which the
Subrecipient is finally determined to be authorized to retain under the terms
of this award; (2) that are determined by the Treasury Office of Inspector
General to have been misused; or (3) that are determined by Treasury to be
subject to a repayment obligation pursuant to sections 602(e) and
603(b)(2)(D) of the Act and have not been repaid by the Subrecipient shall
constitute a debt to the federal government.
b. Any debts determined to be owed to the federal government must be paid
promptly by Subrecipient. A debt is delinquent if it has not been paid by the
date specified in Treasury's initial written demand for payment, unless other
satisfactory arrangements have been made or if the Subrecipient knowingly
or improperly retains funds that are a debt as defined in paragraph 14(a).
Treasury will take any actions available to it to collect such a debt.
15. Disclaimer.
a. The United States expressly disclaims any and all responsibility or liability to
Subrecipient or third persons for the actions of Subrecipient or third persons
resulting in death, bodily injury, property damages, or any other losses
Amendment Contract Number: 23 IBEH 177620 Page 23 of 28
Exhibit F-1
resulting in any way from the performance of this award or any other losses
resulting in any way from the performance of this award or any Agreement,
or Subcontractor under this award.
b. The acceptance of this award by Subrecipient does not in any way establish
an agency relationship between the United States and Subrecipient.
16. Protections for Whistleblowers.
a. In accordance with 41 U.S.C. § 4712, Subrecipient may not discharge, demote,
or otherwise discriminate against an employee in reprisal for disclosing to any of
the list of persons or entities provided below, information that the employee
reasonably believes is evidence of gross mismanagement of a federal Agreement
or grant, a gross waste of federal funds, an abuse of authority relating to a federal
Agreement or grant, a substantial and specific danger to public health or safety,
or a violation of law, rule, or regulation related to a federal Agreement (including
the competition for or negotiation of an Agreement) or grant.
b. The list of persons and entities referenced in the paragraph above includes the
following:
i. A member of Congress or a representative of a committee of Congress;
ii. An Inspector General;
iii. The Government Accountability Office;
iv. A Treasury employee responsible for Agreement or grant oversight or
management;
v. An authorized official of the Department of Justice or other law
enforcement agency;
vi. A court or grand jury; or
vii. A management official or other employee of Subrecipient,
Contractor, or Subcontractor who has the responsibility to
investigate, discover, or address misconduct.
c. Subrecipient shall inform its employees in writing of the rights and remedies
provided under this section, in the predominant native language of the workforce.
17. Increasing Seat Belt Use in the United States. Pursuant to Executive Order 13043, 62
FR 19217 (Apr. 18, 1997), Subrecipient should encourage its Contractors to adopt and
enforce on-the-job seat belt policies and programs for their employees when operating
company -owned, rented or personally owned vehicles.
18. Reducing Text Messaging While Driving. Pursuant to Executive Order 13513, 74 FR
51225 (Oct. 6, 2009), Subrecipient should encourage its employees, Subrecipients,
and Contractors to adopt and enforce policies that ban text messaging while driving,
and Subrecipient should establish workplace safety policies to decrease accidents
caused by distracted drivers.
Amendment Contract Number: 23 IBEH 177620 Page 24 of 28
Exhibit F-1
ASSURANCES OF COMPLIANCE WITH CIVIL RIGHTS REQUIREMENTS
ASSURANCES OF COMPLIANCE WITH
TITLE VI OF THE CIVIL RIGHTS ACT OF
1964
As a condition of receipt of federal financial assistance from the Department of the
Treasury, the Subrecipient provides the assurances stated herein. The federal financial
assistance may include federal grants, loans and Agreements to provide assistance to the
Subrecipient's beneficiaries, the use or rent of Federal land or property at below market value,
Federal training, a loan of Federal personnel, subsidies, and other arrangements with the
intention of providing assistance. Federal financial assistance does not encompass
Agreements of guarantee or insurance, regulated programs, licenses, procurement
Agreements by the Federal government at market value, or programs that provide direct
benefits.
The assurances apply to all federal financial assistance from, or funds made available
through the Department of the Treasury, including any assistance that the Subrecipient may
request in the future.
The Civil Rights Restoration Act of 1987 provides that the provisions of the
assurances apply to all the operations of the Subrecipient's program(s) and activity(ies), so
long as any portion of the Subrecipient's program(s) or activity(ies) is federally assisted in
the manner prescribed above.
1. Subrecipient ensures its current and future compliance with Title VI of the Civil Rights Act
of 1964, as amended, which prohibits exclusion from participation, denial of the benefits of,
or subjection to discrimination under programs and activities receiving federal financial
assistance, of any person in the United States on the ground of race, color, or national origin
(42 U.S.C. § 2000d et seq.), as implemented by the Department of the Treasury Title VI
regulations at 31 CFR Part 22 and other pertinent executive orders such as Executive Order
13166, directives, circulars, policies, memoranda, and/or guidance documents.
2. Subrecipient acknowledges that Executive Order 13166, "Improving Access to Services
for Persons with Limited English Proficiency," seeks to improve access to federally
assisted programs and activities for individuals who, because of national origin, have
Limited English proficiency (LEP). Subrecipient understands that denying a person access
to its programs, services, and activities because of LEP is a form of national origin
discrimination prohibited under Title VI of the Civil Rights Act of 1964 and the
Department of the Treasury's implementing regulations. Accordingly, Subrecipient shall
initiate reasonable steps, or comply with the Department of the Treasury's directives, to
ensure that LEP persons have meaningful access to its programs, services, and activities.
Subrecipient understands and agrees that meaningful access may entail providing
language assistance services, including oral interpretation and written translation where
necessary, to ensure effective communication in the Subrecipient's programs, services,
and activities.
3. Subrecipient agrees to consider the need for language services for LEP persons when
Amendment Contract Number: 23 IBEH 177620 Page 25 of 28
Exhibit F-1
Subrecipient develops applicable budgets and conducts programs, services, and activities.
As a resource, the Department of the Treasury has published its LEP guidance at 70 FR
6067. For more information on taking reasonable steps to provide meaningful access for
LEP persons, please visit http://www.lep.gov.
4. Subrecipient acknowledges and agrees that compliance with the assurances constitutes a
condition of continued receipt of federal financial assistance and is binding upon
Subrecipient and Subrecipient's successors, transferees, and assignees for the period in
which such assistance is provided.
5. Subrecipient acknowledges and agrees that it must require any sub -grantees, contractors,
subcontractors, successors, transferees, and assignees to comply with assurances 1-4
above, and agrees to incorporate the following language in every Agreement or
agreement subject to Title VI and its regulations between the Subrecipient and the
Subrecipient's sub -grantees, Contractors, Subcontractors, successors, transferees, and
assignees:
The sub -grantee, Contractor, Subcontractor, successor, transferee, and assignee shall
comply with Title VI of the Civil Rights Act of 1964, which prohibits Subrecipients of
federal financial assistance from excluding from a program or activity, denying benefits
of or otherwise discriminating against a person on the basis of race, color, or national
origin (42 U.S.C. § 2000d et seq.), as implemented by the Department of the Treasury's
Title VI regulations, 31 CFR Part 22, which are herein incorporated by reference and
made a part of this Agreement (or agreement). Title VI also includes protection to
persons with "Limited English Proficiency" in any program or activity receiving federal
financial assistance, 42
U.S.C. § 2000d et seq., as implemented by the Department of the Treasury's Title VI
regulations, 31 CFR Part 22, and herein incorporated by reference and made a part
of this Agreement or agreement.
6. Subrecipient understands and agrees that if any real property or structure is provided or
improved with the aid of federal financial assistance by the Department of the Treasury, this
assurance obligates the Subrecipient, or in the case of a subsequent transfer, the transferee,
for the period during which the real property or structure is used for a purpose for which the
federal financial assistance is extended or for another purpose involving the provision of
similar services or benefits. If any personal property is provided, this assurance obligates the
Subrecipient for the period during which it retains ownership or possession of the property.
7. Subrecipient shall cooperate in any enforcement or compliance review activities by the
Department of the Treasury of the aforementioned obligations. Enforcement may include
investigation, arbitration, mediation, litigation, and monitoring of any settlement
agreements that may result from these actions. The Subrecipient shall comply with
information requests, on -site compliance reviews and reporting requirements.
8. Subrecipient shall maintain a complaint log and inform the Department of the Treasury of
any complaints of discrimination on the grounds of race, color, or national origin, and limited
English proficiency covered by Title VI of the Civil Rights Act of 1964 and implementing
Amendment Contract Number: 23 IBEH 177620 Page 26 of 28
Exhibit F-1
regulations and provide, upon request, a list of all such reviews or proceedings based on the
complaint, pending or completed, including outcome. Subrecipient also must inform the
Department of the Treasury if Subrecipient has received no complaints under Title VI.
9. Subrecipient must provide documentation of an administrative agency's or court's
findings of non-compliance of Title VI and efforts to address the non-compliance,
including any voluntary compliance or other agreements between the Subrecipient and
the administrative agency that made the finding. If the Subrecipient settles a case or
matter alleging such discrimination, the Subrecipient must provide documentation of
the settlement. If Subrecipient has not been the subject of any court or administrative
agency finding of discrimination, please so state.
10. If the Subrecipient makes sub -awards to other agencies or other entities, the Subrecipient
is responsible for ensuring that sub-Subrecipients also comply with Title VI and other
applicable authorities covered in this document State agencies that make sub -awards
must have in place standard grant assurances and review procedures to demonstrate that
that they are effectively monitoring the civil rights compliance of sub- Subrecipients.
The United States of America has the right to seek judicial enforcement of the terms of this
assurances document and nothing in this document alters or limits the federal enforcement
measures that the United States may take in order to address violations of this document or
applicable federal law.
APPENDIX 4 TO SLFRF EXHIBIT- SLFRF SUBRECIPIENT QUARTERLY
REPORT REQUIREMENTS
1. SLFRF SUBRECIPIENT QUARTERLY REPORT WORKBOOK
1.1 The SLFRF Subrecipient Quarterly Report Workbook must be submitted to the State
Agency within ten (10) days following each quarter ended September, December,
March and June. The SLFRF Subrecipient Quarterly Report Workbook can be found
at: https://osc.colorado.gov/american-rescue-plan-act (see SLFRF Grant Agreement
Templates Tab).
1.2 The requirements set forth in this Appendix 4 do not apply if the instant Agreement is
between two Colorado State Agencies.
Amendment Contract Number: 23 IBEH 177620 Page 27 of 28
Exhibit F-1
APPENDIX 5 TO SLFRF EXHIBIT- SAMPLE SLFRF REPORTING
MODIFICATIONS FORM
Grantee:
Project Title:
Project Duration: I To:
State Agency:
Grant Agreement No:
Project No:
From:
This form serves as notification that there has been a change to the reposing requirements set forth in the original
SLFRF Grant Agreement.
The following reporting requirements have been (add/ remove additional rows as necessary):
By signing this form, the Grantee agrees to and acknowledges the changes to the reporting requirements set
forth in the original SLFRF Grant Agreement. All other terms and conditions of the original SLFRF Grant
Agreement, with any approved modifications, remain in full force and effect. Grantee shall submit this form
to the State Agency within 10 business days of the date sent by that Agency.
Grantee Date
State Agency Grant Manager Date
Amendment Contract Number: 23 IBEH 177620 Page 28 of 28
❑ New Entity?
New Contract Request
Entity Name* Entity ID*
COLORADO DEPARTMENT OF HUMAN @00003650
SERVICES
Contract Name*
COLORADO DEPARTMENT OF HUMAN SERVICES
(AMENDMENT #1 TO THE COUNTY BEHAVIORAL HEALTH
GRANT AGREEMENT)
Contract Status
CTB REVIEW
Contract ID
6523
Contract Lead*
APEGG
Contract Lead Email
apegg@weldgov.com;cobbx
xlk@weldgov.com.
Parent Contract ID
20221204
Requires Board Approval
YES
Department Project*
Contract Description*
ADJUSTING BUDGET. NO CHANGES TO THE BUDGET TOTAL AMOUNT, OR TO THE TERMS, ACTIVITIES AND OBLIGATIONS OF
THE AGREEMENT. AMENDMENT WILL BE SIGNED VIA DOCUSIGN. GRANT AGREEMENT ID (2022-1204) GRANT APPLICATION ID
(2021-3152)
Contract Description 2
PA ROUTING THROUGH THE NORMAL PROCESS. ETA TO CTB. 12+'8;22.
Contract Type*
AMENDMENT
Amount.
$680,165.00
Renewable.
NO
Automatic Renewal
Grant
IGA
Department
HUMAN SERVICES
Department Email
CM-
HumanServices@weldgov.co
Department Head Email
CM-HumanServices-
DeptHead@weldgov.com
County Attorney
GENERAL COUNTY
ATTORNEY EMAIL
County Attorney Email
CM-
COUNTYATTORN EY@WELDG
OV.COM
Requested BOCC Agenda
Date*
12/14/2022
Due Date
12/10/2022
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
Effective Date
Termination Notice Period
Contact Name
PUrchas
Purchasing Approver
Approva
Prod
Department Head
JAMIE ULRICH
DH Approved Date
11/30/2022
8OCC Approved
8OCC Signed Date
8OCC Agenda Date
12/12/2022
Originator
APEGG
Review Date*
05;011/2023
Committed Delivery Date
Contact Type Contact Email
Finance Approver
CHERYL PATTELLI
Renewal Date
Expiration Date*
06/30/2023
Contact Phone 1
Purchasing Approved Date
Finance Approved Date
11 /30/2022
Tyler Ref*
AG 121222
Legal Counsel
MATTHEW .CON ROY
Contact Phone 2
Legal Counsel Approved Date
11/30/2022
Hello