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Home My WebLink About20202390.tiffDeputy Clerk Deputy Clerk to the Board oun"y Attorney RESOLUTION RE: APPROVE AGREEMENT FOR PROFESSIONAL SERVICES FOR NURSING CONSULTATION, CARE MANAGEMENT, AND EDUCATION/TRAINING AND AUTHORIZE CHAIR TO SIGN - NORTH COLORADO HEALTH ALLIANCE 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 an Agreement for Professional Services for Nursing Consultation, Care Management, and Education/Training, 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 North Colorado Health Alliance, commencing July 1, 2020, and ending September 30, 2020, with further terms and conditions being as stated in said agreement, and WHEREAS, after review, the Board deems it advisable to approve said agreement, 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 the Agreement for Professional Services for Nursing Consultation, Care Management, and Education/Training, 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 North Colorado Health Alliance, be, and hereby is, approved. BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to sign said agreement. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 5th day of August, A.D., 2020, nunc pro tunc July 1, 2020. BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO ATTEST: ditAvop;� Weld County Clerk to the Board BY�/ 1^.4,r APP Date of signature: OV1.2/a0 Mike Freeman, Chair Stev oreno, Pro-Tem S ott K. James Kevin D. Ross Cc'. F -1 SD o$l7H /20 2020-2390 HR0092 PRIVILEGED AND CONFIDENTIAL MEMORANDUM DATE July 22, 2020 TO: Board of County Commissioners — Pass -Around FR: Jamie Ulrich, Director, Human Services RE: Agreement for Professional Services with North Colorado Health Alliance 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 Agreement for Professional Services with North Colorado Health Alliance. The Department entered into an agreement with the vendor for the term July 1, 2019 through June 30, 2020. The Department has been in negotiations with the vendor to revise the rate structure in anticipation of a new agreement. On July 22, 2020, the Department was advised that the vendor has elected not to enter into a new agreement. This agreement allows for a 90 -day transition period to allow for current services to complete or for clients to be transferred to alternative services. The major provisions of the Agreement are as follows: Current Term Service/Funding Rate Schedule July 1, 2020 - Nursing Consultation, Care Management and $45.00/Hour (Regular rate of September 30, 2020 Education/Training Services pay for Monday — Friday, 7 a.m.- 7 p.m. and brief interactions, planned visits or administrative functions related to current clients outside of Monday - Friday, 7 a.m.-7p.m.) $0.56/Mile (Travel billed at $0.56 per mile outside of the 30 - mile one-way catchment area from 2930 11th Avenue, Evans, CO 80620. Inclusive of multiple stops.) Pass -Around Memorandum; July 22, 2020 - CMS 3929 2020-2390 PRIVILEGED AND CONFIDENTIAL I do not recommend a Work Session. I recommend approval of the Agreement. Mike Freeman, Chair Scott James Barbara Kirkmeyer Steve Moreno, Pro-Tem Kevin Ross Approve Schedule Recommendation Work Session Other/Comments: Pass -Around Memorandum; July 22, 2020 - CMS 3929 Page 2 WELD COUNTY AGREEMENT FOR PROFESSIONAL SERVICES BETWEEN WELD COUNTY AND NORTH COLORADO HEALTH ALLIANCE (NURSING CONSULTATION, CARE MANAGEMENT AND EDUCATION/TRAINING) THIS AGREEMENT is made and entered into this s ) day of , 2020, by and between the County of Weld, a body corporate and politic of the State of Colorado, by d through its Board of County Commissioners, whose address is 1150 "O" Street, Greeley, Colorado 80631 hereinafter referred to as "County," and North Colorado Health Alliance, who whose address is 2930 11th Avenue, Evans, Colorado 80620, hereinafter referred to as "Contractor". WHEREAS, County desires to retain Contract Professional as an independent Contract Professional to perform services as more particularly set forth below; and WHEREAS, Contract Professional 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, Contract Professional 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 Exhibit A, Scope of Services and Exhibit B, Rate of Services, which forms an integral part of this Agreement. Exhibits A and B are specifically incorporated herein by this reference. 2. Service or Work. Department of Human Services will provide the materials, equipment and/or products necessary for the outlined scope of services and the Contractor agrees to diligently provide all services and labor, as described in Exhibit A. 3. Term. The term of this Agreement shall be from July 1, 2020, through September 30, 2020, or Contractor's completion of the responsibilities described in Exhibit A. This Agreement may be extended annually upon written agreement of both parties. 4. Termination. County has the right to terminate this Agreement, with or without cause on thirty (30) 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. County agrees to pay Contractor through an invoice process during the course of this Agreement in accordance with the Scope of Services as described in Exhibit A. Contractor agrees to submit invoices which detail the work completed by Contractor. The County will review each invoice and if it agrees Contractor has completed the invoiced items to the County's satisfaction, it will remit payment to Contractor. oZoo2o 1 A.5% Contractor agrees to work within the confines of the Scope of Services outlined 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 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. Unemployment insurance benefits will be available to Contractor and its employees and agents only if such coverage is made available by Contractor or a third party. Contractor shall pay when due all applicable employment taxes and income taxes and local head taxes (if applicable) incurred pursuant to this Agreement. 8. Subcontractors. Contractor acknowledges that County has entered into this Agreement in reliance upon the particular reputation and expertise of Contractor. Contractor shall not enter into any subcontractor agreements for the completion of this Project without County's prior written consent, which may be withheld in County's sole discretion. 9. 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 governing 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. 14. 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 2 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 $ 1,000,000 $ 2,000,000 15. 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. 16. Non -Assignment. Contractor may not assign or transfer this Agreement or any interest therein or claim thereunder, without the prior written approval of County. 17. Interruptions. Neither party to this Agreement shall be liable to the other for delays in delivery or failure to deliver or otherwise to perform any obligation under this Agreement, where such failure is due to any cause beyond its reasonable control, including but not limited to Acts of God, fires, strikes, war, flood, earthquakes or Governmental actions. 18. 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. 19. 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. 20. 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. 21. 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. 22. 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. 23. 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. 3 24. 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. 25. 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. 26. 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. 27. 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. 28. 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. 29. 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 a new employee to perform work under the contract, affirm that Contractor has examined the legal work status of such employee, retained file copies of the documents, and not altered or falsified the identification documents for such employees. Contractor shall deliver to County, a written notarized affirmation that it has examined the legal work status of such employee and shall comply with all of the other requirements of the State of Colorado program. If Contractor fails to comply with any requirement of this provision or of C.R.S. §8-17.5- 101 et seq., County, may terminate this Agreement for breach, and if so terminated, Contractor shall be liable for actual and consequential damages. 4 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. 30. 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. COUNTY: ATTEST• de u/O `• '� BOARD OF COUNTY COMMISSIONERS Weld ' o nty, lerk to the B and WELD COUNTY, COLORADO By: Deputy Cle ' tote : o Mike Freeman, Chair AUG 0 5 2020 CONTRACTOR: North Colorado Health Alliance 2930 l 1th Avenue Evans, Colorado 80620 421,LiraN /`1,r Joanna Martinson (Jul 8, 2020 16:29 MDT) Joanna Martinson, Director of Care Coordination By: Date: Jul 8, 2020 5 020 02D - 01390 EXHIBIT A SCOPE OF SERVICES . Contractor will employee Registered Nurses, hereinafter referred to as "R.N." and a Director of Care Coordination who will provide nursing consultation, care management, and education/training services, as well as care management, as requested by the Department for medically fragile children and adults. Primary target population will be medically fragile children, with services available to adults as capacity allows. 2. Department staff will ensure that Contractor is provided with sufficient information regarding the needs of the child or adult to provide adequate services under this agreement. 3. Contractor will ensure that R.N. and Director of Care Coordination maintain current and adequate licensure for the term of the agreement. 4. Services will be accessible to Weld County foster parents and Department caseworkers and supervisors for the purpose of consultation, care management, and education and training. 5. Under this agreement, education and training can include, but is not limited to, basic daily care skills, medical equipment usage and maintenance, medical/behavioral health monitoring, or other areas specific to the medical needs of the child or adult. The overall goal of education and training is to further the knowledge of the caregiver and caseworker to ensure the present and long-term care and safety of the child or adult. 6. Services will be available from the hours of 7:00am to 7:00pm Monday - Friday, via phone. If in person services are deemed necessary and appropriate, the Contractor will provide services on- site or in -home, as applicable. Brief interactions, planned visits or administrative functions related to current clients outside of Monday -Friday, 7:00am to 7:00pm shall be provided and billed at the same rate. 3 7. Contractor understands that "no shows" are defined as unexcused and unplanned/uncommunicated absences for visitation services. The Department will not reimburse for "no shows". The Contractor will notify the caseworker if a client "no shows" so that the caseworker and Contractor can strategize a plan regarding the client's future participation in services. 8. Contractor will be available to be scheduled to accompany caseworkers on home visits to assess medical, environmental, and psychosocial needs when appropriate. 9. Contractor will ensure R.N. continually assesses foster parents or caregivers' capacity to appropriately care for the child. 10. Any agreed upon on -site or in -person services provided will be done so within the scope and skill set of the registered nurse. R.N. will be responsible for obtaining appropriate physician orders for all nursing acts that are outside R.N.'s independent practice and require orders. The treatment plan will be reviewed by and agreed upon by all parties prior to implementation. Any specific equipment and/or supplies that are required to implement the treatment plan will be provided by sources outside of Northern Colorado Health Alliance. Each case will be dealt with on an individual basis. Contractor will supply basic equipment such as thermometers, blood pressure cuffs, and pulse oximeters. 11. Contractor will ensure that the R.N. promptly and appropriately responds to any medical issues that arise during the provision of services per the agreed upon treatment plan. Response may include care management, monitoring, education, and/or intervention as appropriate. Calls will be returned within one hour and assessment will be made to determine if an in -home visit is necessary. Upon review and agreement with the Department and Contractor's Director of Care Coordination; R.N. may provide basic nursing interventions such as medication administration, setting up medication boxes, and other needed interventions. 4 12. Contractor will ensure that the R.N. carries an operating phone for purposes of conducting services and for the purpose of contacting emergency medical personnel (911) should a need arise during the course of on -site or in -person services. Contractor will provide contact information for the R.N. 13. Contractor will appropriately document and communicate care needs to the Department in a timely manner_ 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 (FIDOS), unless otherwise directed by the Department. 15. Contractor will submit signed verification forms for all client face to face contact monthly with the invoice. Contractor will also submit timesheets and mileage forms monthly with the invoice. 16. Services will be deemed successful through the following: • Increased knowledge on the part of the caseworker and/or foster parent/caregiver regarding the specific medical needs of the child or adult. Follow-through with implementation of interventions determined through assessment, consultation, and treatment planning regarding the child's oradult's needs. • Visualized ongoing well-being and care of the child or adult. Satisfaction of all parties with the level and quality of services rendered and information exchanged. • At least 95% of children who are in home with nurse involvement should remain home. • At least 90% of the children in Weld County Foster homes who have nurse involvement should maintain placement or return home • 100% of the prevention cases the nurse is involved with will not enter child welfare anytime during the nurse engagements. 90% of children in Weld County Foster homes who returned home and had nurse involvement will not re-enter placements. 5 EXHIBIT B RATE OF SERVICES 1. Funding and Method of Payment The Department agrees to reimburse the Contractor in consideration of the work and services performed under this Agreement at the rate 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 June 30, 2020. Expenses incurred by the Contractor prior to the term of this Agreement are not eligible Department expenditures and shall not be reimbursed by the Department. 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 $45.00/Hour (Regular rate of pay for Monday -Friday, 7 a.m.-7 p.m. and brief interactions, planned visits or administrative functions related to current clients outside of Monday -Friday, 7 a.m.-7 p.m.) $0.56/Mile (Travel billed at $0.56 per mile outside of the 30 -mile one-way catchment area from 2930 l lth Avenue, Evans, CO 80620. Inclusive of multiple stops.) 3. Submittal of Vouchers Contractor shall prepare and submit a monthly itemized invoice, including timesheets, mileage forms and signed verification forms, certifying that services authorized were provide on the date(s) indicated and charges made were pursuant to the terms and conditions of Exhibit A. Contractor shall submit all monthly billings and applicable reports to the Department by 7th Day of the month following the month the cost was incurred. Failure to submit by the aforementioned deadline may result in forfeiture of payment. 6 KAMUSSEN RTCOL-08 1 ACOREY `� CERTIFICATE OF LIABILITY INSURANCE DATE(MWDD/YYYY) 7/22/2020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER License # 0757776 HUB International Insurance Services (COL) 2000 S. Colorado Blvd Tower 2, Suite 150 Denver, CO 80222 CONTACT PHONE FAX (A/C, No, Ext): (303) 893-0300 (A/C, No):(866) 243-0727 AIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Alliance of Nonprofits for Insurance, Risk Retention Group (ANI) 10023 INSURED North Colorado Health Alliance aka Sunrise Community Health 2930 11th Avenue Evans, CO 80620 INSURER B : INSURER C INSURER D : INSURER E : INSURER F : REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE FOLIC ES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF IMM/DD/YYYY) POLICY EXP IMM/DDIYYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY X 2020-23526 6/16/2020 6/16/2021 EACH OCCURRENCE $ 1,000,000 PAMAGE TO RENTED PREMISES R occurrence) 500,000 $ CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 20,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE POLICY OTHER: LIMIT APPLIES FeT PER: LOC PRODUCTS - COMP/OP AGG $ 2,000,000 LIQUOR LIABILIT $ 1,000,000 A AUTOMOBILE _ X LIABILITY ANY AUTO OWNED AUTOS ONLY HIRED ONLY x SCHEDULED AUTOS NON-OWNED ONEYY 2020-23526 6/16/2020 6/16/2021 COMBINED SINGLE LIMIT (Ea accident) 1,000,000 $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY acEcidentDAMAGE $ $ ._UMBRELLA LIAB EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ $ DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N /A PER STATUTE OTH- ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ A Professional Liabili 2020-23526 6/16/2020 6/16/2021 Occurrence 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Additional Insured: Board of County Commissioners of Weld County and its Officers/Employees CERTIFICATE HOLDER CANCELLATION County of Weld 1150 "O" Street 80631 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE I �1 ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 2018-23526 COMMERCIAL GENERAL LIABILITY Named Insured: North Colorado Health Alliance THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE CG 20 26 04 13 Name Of Additional Insured Person(s) Or Organization(s): Any person or organization that you are required to add as an additional insured on this policy, under a written contract or agreement currently in effect, or becoming effective during the term of this policy. The additional insured status will not be afforded with respect to liability arising out of or related to your activities as a real estate manager for that person or organization. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 26 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 New Contract Request Entity information Entity Name NORTH COLORADO HEALTH ALLIANCE Contract Name * NORTH COLORADO HEALTH ALLIANCE Contract Status CTB REVIEW Entity ID* @00019419 L7 New Entity? Contract ID 3929 Contract Lead * CULLINTA Contract Lead Email cullinta@coweld.co.us:cobbx-x k@coweld.co.us Parent Contract ID Requires Board Approval YES Department Project # Contract Description AGREEMENT FOR PROFESSIONAL SERVICES, TERM: JULY 1, 20;20 THROUGH SEPTEMBER 30. 2020. SERVICES INCLUDE NURSING CONSULTATION, CARE MANAGEMENT AND EDUCATION,TRAINING. Contract Description 2 Contract Type* AGREEMENT Amount* $0 00 Renewable* NO Automatic Renewal Grant IGA Department HUMAN SERVICES Department Email CM- Huma nSer,'ices@weldgov.com Department Head Email CM-HurnanServices- DeptHead@weldgov.com County Attorney GENERAL COUNTY ATTORNEY EMAIL. County Attorney Email CM- COUNTYA I I ORNEY@WELD GOV.COM Requested BOCC Agenda Date * 08:0512020 Due Date 0810112020 Will a work session with SOCC 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 he left blank if those contracts are not in OnBase Contract Dates Effective Date Review Date * Renewal Date USt3112020 Termination Notice Period Committed Delivery Date Expiration Date 0913012020 Contact Information Contact Info Contact Name Contact Type Contact Email Contact Phone 1 Contact Phone 2 Purchasing Purchasing Approver Approval Process Department Head JAMIE ULRICH OH Approved Date 07'27/2020 Final Approval BOCC Approved BOCC Signed Date BOCC Agenda Date 08105/2020 Originator SNYDERKL Finance Approver BARB CONNOLLY Purchasing Approved Date Finance Approved Date 07128/2020 Tyler Ref # AG 080520 Legal Counsel GABE KALOUSEK Legal Counsel Approved Date 07.''25/2020 Hello