HomeMy WebLinkAbout20210017.tiffPRIVILEGED AND CONFIDENTIAL
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MEMORANDUM
DATE: December 22, 2020
TO: Board of County Commissioners — Informational
Memorandum
FR: Jamie Ulrich, Director, Human Services
RE: Department of Human Services Provisional
Agreement with Dr. Jacob A. Jones
The Department of Human Services (DHS), Division of Child Welfare (CW), has two (2) children placed
in Grand Junction, Colorado in need of psychological testing. One of the children required additional
psychological testing for an appeal for Supplemental Security Income (SSI) determination. Due to the
deadline for documentation related to this appeal, CW requested that a Provisional Agreement for Mental
Health Evaluation Services be developed with Dr. Jacob A. Jones, a local provider in the Grand Junction
area.
Dr. Jones has agreed to provide Mental Health Evaluation services to both children within the ninety
(90) -day window allowed under the Provisional Agreement. Services will be reimbursed at a rate of
$350.00 per hour for direct face-to-face time with the children.
Per authority given through the resolution, identified as Tyler ID 2019-4388, a Provisional Agreement for
Mental Health Evaluation Services was signed by the Director of Human Services and executed on
December 9, 2020. The term dates of the agreement are December 7, 2020 to March 7, 2021.
Information Memorandum; December 22, 2020 — ID 4340
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2021-0017
H 8009 3
WELD COUNTY PROVISIONAL AGREEMENT FOR PROFESSIONAL SERVICES
BETWEEN WELD COUNTY & JACOB A. JONES DBA DRS. JONES PSYCHOLOGICAL SERVICES
YOUTH PSYCOLOGICAL TESTING
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THIS AGREEMENT is made and entered into this —1. day of Upon. _, 2021, by and between the County of
Weld, a body corporate and politic of the State of Colorado, by and through the Weld County Department of Human Services
as designee for the Board of County Commissioners pursuant to Weld County Code Section 5-4-60(B), whose address is
315 North 11'" Avenue, Greeley, Colorado 80631 hereinafter referred to as "County," and Jacob A. Jones DBA Drs. Jones
Psychological Services, a limited liability company, who whose address is 593 Village Way. Grand Junction. Colorado
81507, hereinafter referred to as "Contractor".
WHEREAS, County desires to retain Contractor as an independent Contract Professional to perform certain
services on a temporary or provisional basis because of an immediate need for the identified service; and
WHEREAS, Contractor has the ability, qualifications, and time available to timely perform the services, and is
willing to perform the services according to the terms of this Agreement.
WHEREAS, Contractor is authorized to do business in the State of Colorado and has the time, skill, expertise, and
experience necessary to provide the services as set forth below;
NOW, THEREFORE, in consideration of the mutual promises and covenants contained herein, the parties hereto
agree as follows:
1. Introduction. The terms of this Agreement are contained in the terms recited in this document and in Exhibits A and B
which form an integral part of this Agreement. Exhibits A and B are specifically incorporated herein by this reference. This
Agreement is a provisional agreement only and is to be used in situations where an urgent need for a specific service has
been identified by the County prior to completion of a full contract.
2. Service or Work. Contractor agrees to procure the materials, equipment and/or products necessary for the Project and
agrees to diligently provide all services, labor, personnel and materials necessary to perform and complete the Project
described in Exhibit A.
3. Term. This Agreement shall become effective on December 7, 2020, upon proper execution of this Agreement and shall
expire March 7, 2021, unless sooner terminated as provided herein. This Agreement is for a period of no more than ninety
(90) days and may not be renewed. .
3a. Limitations on Agreement. This agreement may only be for ninety (90) days and for services under twenty-five
thousand ($25,000) dollars. It is not meant to allow Contractor to avoid the formal bidding process required by Colorado
Revised Statutes and Colorado Rules. Therefore, a vendor may only be accessed through this provisional agreement process
twice before having to formally respond to the County's bid for services, if the Contractor wishes to continue to provide
services to the County.
4. Termination. County has the right to terminate this Agreement, with or without cause on ten (10) days written notice.
Furthermore, this Agreement may be terminated at any time without notice upon a material breach of the terms of the
Agreement.
5. Extension or Modification. Any amendments or modifications to this agreement shall be in writing signed by both
parties. No additional services or work performed by Contractor shall be the basis for additional compensation unless and
until Contractor has obtained written authorization and acknowledgement by County for such additional services.
6. Compensation/Contract Amount. Upon Contractor's successful completion of the Project, and County's acceptance
of the same, County agrees to pay an amount no greater than $25,000 for the services as set forth in Exhibit A. County will
not withhold any taxes from monies paid to the Contractor hereunder and Contractor agrees to be solely responsible for the
accurate reporting and payment of any taxes related to payments made pursuant to the terms of this Agreement.
7. Independent Contractor. Contractor agrees that it is an independent Contractor and that Contractor's officers, agents
OO`al- l - 0011
or employees will not become employees of County, nor entitled to any employee benefits from County as a result of the
execution of this Agreement. Contractor shall perform its duties hereunder as an independent Contractor. Contractor shall
be solely responsible for its acts and those of its agents and employees for all acts performed pursuant to this Agreement.
Contractor, its employees and agents are not entitled to unemployment insurance or workers' compensation benefits through
County and County shall not pay for or otherwise provide such coverage for Contractor or any of its agents or employees.
8. Subcontractors. Contractor acknowledges that County has entered into this Agreement in reliance upon the particular
reputation and expertise of Contractor. Contractor shall not enter into any subcontractor agreements for the completion of
this Project without County's prior written consent, which may be withheld in County's sole discretion.
4. Ownership. All work and information obtained by Contractor under this Agreement or individual work order shall
become or remain (as applicable), the property of County.
10. Confidentiality. Contractor agrees to keep confidential all of County's confidential information. Contractor agrees
not to sell, assign, distribute, or disclose any such confidential information to any other person or entity without seeking
written permission from the County. Contractor agrees to advise its employees, agents, and consultants, of the confidential
and proprietary nature of this confidential information and of the restrictions imposed by this agreement.
11. Warranty, Contractor warrants that the services performed under this Agreement will be performed in a manner
consistent with the standards goveming such services and the provisions of this Agreement. Contractor further represents
and warrants that all services shall be performed by qualified personnel in a professional and workmanlike manner,
consistent with industry standards, and that all services will conform to applicable specifications.
12. Acceptance of Services Not a Waiver. In no event shall any action by County hereunder constitute or be construed
to be a waiver by County of any breach of this Agreement or default which may then exist on the part of Contractor.
Acceptance by the County of, or payment for, the services completed under this Agreement shall not be construed as a
waiver of any of the County's rights under this Agreement or under the law generally.
13. Insurance and Indemnification. Contractor shall procure at least the minimum amount of automobile liability
insurance required by the State of Colorado for the use of any personal vehicle. Proof of said automobile liability insurance
shall be provided to County prior to the performance of any services under this Agreement. Professional Liability (Errors
and Omissions Liability) The policy shall cover professional misconduct or lack of ordinary skill for those positions
defined in the Scope of Services of this contract. Contract Professional shall maintain limits for all claims covering wrongful
acts, errors and/or omissions, including design errors, if applicable, for damage sustained by reason of or in the course of
operations under this Contract resulting from professional services. In the event that the professional liability insurance
required by this Contract is written on a claims -made basis, Contract Professional warrants that any retroactive date under
the policy shall precede the effective date of this Contract; and that either continuous coverage will be maintained or an
extended discovery period will be exercised for a period of two (2) years beginning at the time work under this Contract is
completed.
Minimum Limits:
Per Loss
Aggregate
S 1,000,000
S 2,000,000
14. Indemnity. The Contractor shall defend, indemnify and hold harmless County, its officers, agents, and employees,
from and against injury, loss damage, liability, suits, actions, or claims of any type or character arising out of the work done
in fulfillment of the terms of this Contract or on account of any act, claim or amount arising or recovered under workers'
compensation law or arising out of the failure of the Contractor to conform to any statutes, ordinances, regulation, law or
court decree.
15. Non -Assignment. Contractor may not assign or transfer this Agreement or any interest therein or claim thereunder,
without the prior written approval of County.
16. Interruptions. Neither party to this Agreement shall be liable to the other for delays in delivery or failure to deliver or
otherwise to perform any obligation under this Agreement, where such failure is due to any cause beyond its reasonable
control, including but not limited to Acts of God, fires, strikes, war, flood, earthquakes or Govemmental actions.
17. Compliance with Law. Contractor shall strictly comply with all applicable federal and State laws, rules and regulations
in effect or hereafter established, including without limitation, laws applicable to discrimination and unfair employment
practices.
18. Non -Exclusive Agreement. This Agreement is nonexclusive and County may engage or use other Contractors or
persons to perform services of the same or similar nature.
19. Entire Agreement/Modifications. This Agreement including the Exhibits attached hereto and incorporated herein,
contains the entire agreement between the parties with respect to the subject matter contained in this Agreement. This
instrument supersedes all prior negotiations, representations, and understandings or agreements with respect to the subject
matter contained in this Agreement. This Agreement may be changed or supplemented only by a written instrument signed
by both parties.
20. Fund Availability. Financial obligations of the County payable after the current fiscal year are contingent upon funds
for that purpose being appropriated, budgeted and otherwise made available. Execution of this Agreement by County does
not create an obligation on the part of County to expend funds not otherwise appropriated in each succeeding year.
21. Employee Financial Interest/Conflict of Interest — C.R.S. §§24-18-201 et seq. and §24-50-507. The signatories to
this Agreement state that to their knowledge, no employee of Weld County has any personal or beneficial interest
whatsoever in the service or property which is the subject matter of this Agreement.
22. Severability. If any term or condition of this Agreement shall be held to be invalid, illegal, or unenforceable by a
court of competent jurisdiction, this Agreement shall be construed and enforced without such provision, to the extent that
this Agreement is then capable of execution within the original intent of the parties.
23. Governmental Immunity. No term or condition of this contract shall be construed or interpreted as a waiver, express
or implied, of any of the immunities, rights, benefits, protections or other provisions, of the Colorado Governmental
Immunity Act §§24-10-101 et seq., as applicable now or hereafter amended.
24. No Third Party Beneficiary. It is expressly understood and agreed that the enforcement of the terms and conditions
of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties
and nothing in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included
in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties
receiving services or benefits under this Agreement shall be an incidental beneficiary only.
25. Board of County Commissioners of Weld County Approval. This Agreement shall not be valid until it has been
approved by the Board of County Commissioners of Weld County, Colorado or its designee.
26. Choice of Law/Jurisdiction. Colorado law, and rules and regulations established pursuant thereto, shall be applied in
the interpretation, execution, and enforcement of this Agreement. Any provision included or incorporated herein by
reference which conflicts with said laws, rules and/or regulations shall be null and void. In the event of a legal dispute
between the parties, Contractor agrees that the Weld County District Court shall have exclusive jurisdiction to resolve said
dispute.
27. Public Employment Retirement Program. Contractor is responsible for notifying Weld County of any previous
participation in the Colorado Public Employee Retirement Program. Contractor must notify Weld county of the most recent
employment for a PERA contributing employer.
28. Public Contracts for Services C.R.S. §8-17.5-101. Contractor certifies, warrants, and agrees that it does not
knowingly employ or contract with an illegal alien who will perform work under this contract. Contractor will confirm the
employment eligibility of all employees who are newly hired for employment in the United States to perform work under
this Agreement, through participation in the E -Verify program or the State of Colorado program established pursuant to
C.R.S. §8-17.5-102(5)(c). Contractor shall not knowingly employ or contract with an illegal alien to perform work under
this Agreement or enter into a contract with a subcontractor that fails to certify with Contractor that the subcontractor shall
not knowingly employ or contract with an illegal alien to perform work under this Agreement. Contractor shall not use E -
Verify Program or State of Colorado program procedures to undertake pre -employment screening or job applicants while
this Agreement is being performed. If Contractor obtains actual knowledge that a subcontractor performing work under the
public contract for services knowingly employs or contracts with an illegal alien Contractor shall notify the subcontractor
and County within three (3) days that Contractor has actual knowledge that a subcontractor is employing or contracting
with an illegal alien and shall terminate the subcontract if a subcontractor does not stop employing or contracting with the
illegal alien within three (3) days of receiving notice. Contractor shall not terminate the contract if within three days the
subcontractor provides information to establish that the subcontractor has not knowingly employed or contracted with an
illegal alien. Contractor shall comply with reasonable requests made in the course of an investigation, undertaken
pursuant to C.R.S. §8-17.5-102(5), by the Colorado Department of Labor and Employment. If Contractor participates in
the State of Colorado program, Contractor shall, within twenty days after hiring an new employee to perform work under
the contract, affirm that Contractor has examined the legal work status of such employee, retained file copies of the
documents, and not altered or falsified the identification documents for such employees. Contractor shall deliver to County,
a written notarized affirmation that it has examined the legal work status of such employee, and shall comply with all of the
other requirements of the State of Colorado program. If Contractor fails to comply with any requirement of this provision
or of C.R.S. §8-17.5-101 et seq., County, may terminate this Agreement for breach, and if so terminated, Contractor shall
be liable for actual and consequential damages.
Except where exempted by federal law and except as provided in C.R.S. § 24-76.5-103(3), if Contractor receives federal or
state funds under the contract, Contractor must confirm that any individual natural person eighteen (18) years of age or older
is lawfully present in the United States pursuant to C.R.S. § 24-76.5-103(4), if such individual applies for public benefits
provided under the contract. If Contractor operates as a sole proprietor, it hereby swears or affirms under penalty of perjury
that it: (a) is a citizen of the United States or is otherwise lawfully present in the United States pursuant to federal law, (b)
shall produce one of the forms of identification required by C.R.S. § 24-76.5-101, et seq., and (c) shall produce one of the
forms of identification required by C.R.S. § 24-76.5-103 prior to the effective date of the contract.
29. Acknowledgment. County and Contractor acknowledge that each has read this Agreement, understands it and agrees
to be bound by its terms. Both parties further agree that this Agreement, with the attached Exhibits A and B, is the complete
and exclusive statement of agreement between the parties and supersedes all proposals or prior agreements, oral or written,
and any other communications between the parties relating to the subject matter of this Agreement.
IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year
first above written.
CONTRACTOR:
Jacob A. Jones DBA Drs. Jones Psychological Services
By: jai* AJones(� 01438NST) Date Dec 9 2020
Name: Dr. Jacob A. Jones
Title: Psychologist
COUNTY:
Weld County Government
9aitra-terick
By: Jamie Ulrich (Dec 9, 202014:14 MST)
Name: Jamie Ulrich
Title: Director of Human Services
Date Dec 9, 2020
EXHIBIT A
SCOPE OF SERVICES
1. Contractor will provide Mental Health Evaluation Services, as referred by the
Department. The following services are available under this Agreement:
a. Individual Psychological Evaluation: A thorough intellectual and diagnostic
assessment, to include formal psychological testing and a review of social history,
Family Service Plans and collateral information. Individual Psychological
Evaluations will address referral questions regarding diagnoses and their impact
on attachment and parenting, placement and visitation needs, and other treatment
recommendations.
b. Mental Health Assessment (MHA): A brief assessment of mental health
functioning to answer diagnostic questions outlined by the Department and to
provide treatment recommendations. Mental Health Assessments will include a
review of WCDHS social history and family services plans but limited outside
collateral information. Psychological screening instruments will be completed,
but no formal psychological testing. If psychological testing is indicated, a
Psychological Evaluation may be recommended for approval by the Department.
2. Capacity: As needed. Contractor will complete Mental Health Assessments (MHA)
within in one (1) month or less and Individual Psychological Evaluations will be
completed within two (2) months or less.
3. Goals of Service:
a. Provide individual diagnostic evaluations to assess individual functioning to assist
in the development of Family Service Plans and provide treatment
recommendations.
b. Support the goals established by the Court and in the child(ren)'s best interests for
safety, permanency and well-being.
4. Outcomes of Service:
a. A final diagnostic feedback session will be offered to the client to discuss
psychological test results, findings and recommendations of the evaluation.
b. A written report will be provided for all evaluations summarizing the referral
questions, brief case and social history, evaluation course, methods and
procedures, assessment findings, collateral contacts, limitations, analysis, and
conclusions and recommendations for visitation, treatment, medication evaluation
or future psychological evaluation.
i. Incomplete evaluations will be documented to the extent possible and will
outline the limitations and impact of any missing information.
5. Target Population:
a. Children, ages birth to 12 years.
b. Adolescents, ages 13 to 18 years.
c. Adults, over the age of 18 years.
d. All genders.
6. Service Access:
106 Lorey Drive
Grand Junction, Colorado 81505
7. Language: English
8. Contractor will respond to the Quality Assurance Team Supervisor
(hainlejd(i6veldgov.com, 970-400-6210) within three (3) business days regarding the
ability to accept the received referral.
9. Upon acceptance of a referral, Contractor will offer an initial appointment within seven
(7) days of receiving the referral. The first attempt to contact the client will occur within
24 hours of receiving the referral (excluding weekends and holidays). Contractor will
document efforts to engage client in referred services. If the client does not respond after
three (3) attempts in the first seven (7) days of the referral period, the Contractor will
notify the caseworker and the Quality Assurance Team Supervisor
(hainlejd(iweldgov.com, 970-400-6210).
10. Contractor understands that "no shows" are defined as unexcused and
unplanned/uncommunicated absences for visitation services. If a rate for "no shows" is
not specifically stated in Exhibit D, Rate Schedule, then Contractor understand that the
Department will no reimburse for "no shows". Contractor understands that the
Department will only reimburse Contractor for up to two (2) "no-shows" on the part of
the client per month. After three (3) "no-shows, "Contractor will place client on a
behavioral plan requiring attendance or discharged client from services. Contractor must
inform the caseworker and the Quality Assurance Team Supervisor
(hainlejda weldgov.com, 970-400-6210).
11. Contractor understands that the Department will not reimburse Contractor for cancelled
appointments either on the part of the client or the Contractor. If the cancellation is
generated from the Contractor, a "makeup" session/episode, to occur within 30 days of
the cancellation, will be offered to the client (excluding session/episodes that fall on
holidays). If the cancellation is generated from the client, the Contractor must request a
makeup session from the Department prior to the makeup session occurring (excluding
session/episodes that fall on holidays). After three (3) cancellations, Contractor will
inform the caseworker and the Quality Assurance Team Supervisor
(hainleida,weldgov.com) immediately via email, to discuss service continuation.
12. Contractor will identify in detail areas of continued concern and make recommendations
to the Department regarding continuation of services and/or the need for additional
services.
13. Contractor will document in detail any and all observed or verbalized concerns regarding
any child whom the Contractor is working with under an active referral. Areas of
concern may include, but are not limited to, any physical, emotional, educational or
behavioral issues. Areas of concern should be reported immediately AND on the
required monthly report.
14. Contractor will submit reports on a monthly basis for each active referral for ongoing
services. Reports will be submitted per the online format required by the Department,
unless otherwise directed by the Department.
15. Contractor agrees any change to an existing referral must be pre -approved through the
Child Welfare Contract and Services Coordinator, a Department -facilitated Team
Decision Making (TDM) or Family Team Meeting (FTM), or by court order. A change
is defined as anything outside of the approved documented service on the initial
authorized referral form. This may include an increase or decrease in services hours,
change in frequency, change in location of services, transportation needs, or any change
to the initial referral or subsequent authorizations.
16. Contractor agrees to attend meetings when available and as requested by the Department.
Such meetings include Court Facilitations, Court Staffings, Family Team Meetings
and/or Team Decision Making meetings. The Department will reimburse for actual
participation in the meeting only so long as the meeting is at least one hour in length, the
Contractor obtains the Facilitator's signature on the Client Verification Form (if in
person) at the time of the meeting and participation in the meeting is deemed appropriate
and necessary by the Department. Staffings and/or meetings other than those listed above
are not considered reimbursable unless otherwise approved by the Child Welfare
Contract and Services Coordinator. Contractor may participate by phone, if approved by
the Department.
17. Contractor will notify the Quality Assurance Team Supervisor (hainlejd cr weldgov.com,
970-400-6210) of new staff who will manage and/or administer the services with the
following information:
a. Staff member name and contact information
b. Education level/degree (if applicable)
c. Licensure/credentials (if applicable)
d. Department of Regulatory Authority (DORA) number (if applicable)
e. Supervisor name and contact information
The Department reserves the right to decline the new staff members managing and/or
administering services to Department clients.
EXHIBIT B
RATE SCHEDULE
�. Funding and Method of Payment
The Department agrees to reimburse the Contractor in consideration of the work and
services performed under this Agreement at the rate specific in Paragraph 2, below. The
total amount to be paid to the Contractor during the term of this Agreement shall be
reported by the Department after May 31, 2021.
Expenses incurred by the Contractor prior to the tern of this Agreement are not eligible
Department expenditures and shall not be reimbursed by the Department.
Payment pursuant to this Agreement, whether in whole or in part, is subject to and
contingent upon the continuing availability of said funds for the purposes hereof. In the
event that said funds, or any part thereof, become unavailable as determined by the
Department, the Department may immediately terminate the Agreement or amend it
accordingly.
2. Fees for Services
Psychological testing
$350.00/Hour (Rate is for direct face-to-face time only).
3. Submittal of Vouchers
Contractor shall prepare and submit monthly a Request for Reimbursement, Client
Verification Form, other supporting documentation, and monthly report if applicable,
certifying that services authorized were provided on the date(s) indicated and the charges
were made pursuant to the terms and conditions of Paragraph 3 and Exhibit A.
Contractor shall submit all Requests for Reimbursement and supporting documentation to
the Department by the rh day of the month following the month of service, but no later
than 60 days from the date of service. Requests for Reimbursement and/or supporting
documentation received after 60 days from the date of service may result in delay or
forfeiture of payment. Consistent failure to meet the 60 -day deadline may result in
termination of the Agreement.
For ongoing services, proof of services rendered shall be a Client Verification Form
signed by the client and a monthly report submitted in accordance with Paragraph 3(d) of
this Agreement.
For one-time services, proof of services rendered shall be receipt of a Client Verification
Form and the completed product.
For Monitored Sobriety services, proof of services rendered shall be the test result.
Contract Form
Entity Information
Entity Name*
JONES, JACOB
New Contract Request
Entity ID*
,.00043171
Contract Name*
DR. JACOB JONES PROVISIONAL AGREEMENT
Contract Status
CTB REVIEW
New Entity?
Contract ID
4340
Contract Lead*
APEGG
Contract Lead Email
apegg@weldgov.com,cobbx
xlk(Pweldgov.com
Parent Contract ID
Requires Board Approval
YES
Department Project #
Contract Description*
MENTAL HEALTH SERVICES. TERM: DECEMBER 7, 2020 THROUGH MARCH 7, 2021. THIS ITEM IS RUNNING AS CONSENT
THROUGH CMS.
Contract Description 2
NO PA. AN INFORMATIONAL MEMORANDUM WILL BE SENT TO THE BOCC ON 1 2 r22;`2020.
Contract Type*
AGREEMENT
Amount*
50.00
Renewable*
NO
Automatic Renewal
Grant
IGA
Department Requested BOCC Agenda Due Date
HUMAN SERVICES Date* 12 26'2020
12 30;2020
Department Email
CM-
HurnanServices@weldgov.co
m
Department Head Email
CM-HumanServices-
DeptHeadgweldgov.com
County Attorney
GENERAL COUNTY
ATTORNEY EMAIL
County Attorney Email
CM-
COUNTYATTORNEY 2WELDG
OV.COM
Will a work session with BOCC be required?*
NO
Does Contract require Purchasing Dept. to be included?
If this is a renewal enter previous Contract ID
If this is part of a MSA enter MSA Contract ID
Note: the Previous Contract Number and Master Services Agreement Number- should be left blank if those contracts are not in
OnBase
Contract Dates
Effective Date
Review Date*
01;07,2021
Renewal Date
Termination Notice Period
Contact Inforttation
Contact Info
Contact Name
Purchasing
Purchasing Approver
CONSENT
Approval Process
Department Head
JAMIE ULRICH
DH Approved Date
12/28/2020
Final Approval
BOCC Approved
BOCC Signed Date
BOCC Agenda Date
01/0412021
Originator
APEGG
Committed Delivery Date
Expiration Date*
03/07x'2021
Contact Type Contact Email Contact Phone 1 Contact Phone 2
Finance Approver
CONSENT
Purchasing Approved Date
12; 28;2020
Legal Counsel
CONSENT
Finance Approved Date Legal Counsel Approved Date
12/28/2020 12/28x`2020
Tyler Ref *
AG 010421
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