HomeMy WebLinkAbout20201377.tiffCHILD PROTECTION AGREEMENT FOR SERVICES
BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES
AND TINDALL, BARTELS & ASSOCIATES
This Agreement, made and entered into thdLday of 2020, by and between the Board of Weld
County Commissioners, on behalf of the Weld County Department of man Services, hereinafter referred to as
the "Department' and Tindall, Bartels & Associates, hereinafter referred to as the "Contractor".
The parties to this Agreement understand and agree that the provisions of this Agreement specifically
include the following documents: Exhibit A, Weld County's Request for Proposal, Exhibit B, Contractor's Response
to Request for Proposal, Exhibit C, Scope of Services, and Exhibit D, Rate Schedule. Exhibit B, C, and D are attached
hereto and incorporated herein by this reference. Exhibit A is Weld County's Request for Proposal Number
B2000037, which is incorporated into this agreement by reference and will be provided upon request to the
Department.
WITNESSETH
WHEREAS, required approval, clearance, and coordination have been accomplished from and with
appropriate agencies; and
WHEREAS, the Colorado Department of Human Services has provided Child Welfare Administration or
other funding to the Department for Mental Health Services and Sexual Abuse Treatment.
NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows:
1. Term
This agreement shall become effective on June 1, 2020, upon proper execution of this Agreement and
shall expire May 31, 2021, unless sooner terminated as provided herein. The agreement is for a period of
three years. However, the agreement must be renewed by both parties, in writing, on an annual basis.
2. Scope of Services
Services shall be provided by the Contractor to any person(s) eligible for services in compliance with
Exhibit B, Contractor's Response to Request for Proposal and Exhibit C, Scope of Services.
3. Referrals, Billing and Tracking
a. Contractor understands and will comply with all aspects of the referral authorization, billing and
tracking requirements as set forth by the Department. Failure to comply with all aspects may result
in a forfeiture of payment.
b. Contractor agrees to receive referrals for services through e-mail and will provide an identified e-
mail address prior to the start of this Agreement. Contractor acknowledges that services are not
authorized until the Contractor has received an authorized referral form from the Department.
Contractor further acknowledges that services provided prior to the authorized start date or outside
the scope of services on the referral form will not be eligible for reimbursement.
Contractor acknowledges that any and all modifications to an existing referral must be approved
through the Quality Assurance Team Supervisor (hainleid@weldgov.com, 970-400-6210). No other
Department staff or other party to the case may authorize services or modifications to services.
CG H50 Onbtaae,
o5/(a/,Do
02.1)
2020-1377
c. Contractor agrees to submit a complete Request for Reimbursement and supporting documentation
by the 7th of the month, following the month of service, utilizing billing forms required by the
Department. Contractor agrees to utilize the Client Verification Form for all scheduled and
unscheduled face-to-face services with the exception of one-time services (ex. home studies,
evaluations and monitored sobriety testing). Contractor agrees that original complete Client
Verification Forms with original signatures are to be submitted with the Request for Reimbursement.
Requests for Reimbursement and Client Verification Forms received after 60 days from the date of
service may result in delay or forfeiture of payment. Consistent failure to meet 60 -day deadline may
result in termination of the Agreement.
d. Contractor agrees to submit a monthly report by the 7th of the month, following the month of service,
for each client receiving ongoing services. Monthly reports will be submitted through the
Department's online reporting system, unless otherwise directed or agreed to by the Department.
Monthly reports for ongoing services must include the following information, entered in the
"Narrative" box for each date of service:
a. Date and time of service
b. Where the service took place
c. Clinician/therapist name
d. Clients participating
e. What interventions were used, recommendations and/or goals discussed
f. Any and all safety concerns
One-time services will be verified through receipt of the completed product (ex. evaluations,
substance abuse evaluation, home study). Verification of Monitored Sobriety Services will be the test
result. A completed home study may be a full, partial or denied study, as determined by the
Department.
Contractor will document in detail any and all observed or verbalized concerns regarding any child
whom the Contractor is working with under the Agreement. Areas of concern may include, but are
not limited to, any physical, emotional, educational or behavioral issues. Areas of concern should be
reported immediately to the caseworker AND on the required monthly report.
4. Payment
a. The Department and the Contractor agree that all benefits from private insurance and/or other
funding sources such as Medicaid (if Contractor is a Medicaid eligible provider) or Victim's
Compensation must be exhausted before Core Services or other Department funds can be accessed
for services. Exceptions to this Paragraph may include, if approved by the Department, the following:
i. The service being provided by the contractor is not a Medicaid eligible service;
ii. The service is not deemed medically necessary;
iii. The Court with jurisdiction over the case has ordered that a non -Medicaid provider
or service be used;
iv. A Medicaid provider is not available to provide the needed service;
v. Medicaid is exhausted for the needed service; or
vi. Medicaid denied service.
vii. The client is not eligible for Medicaid.
b. Payment shall be made in accordance with Exhibit A, Weld County's Request for Proposal, Exhibit
B, Contractor's Response to Request for Proposal, Exhibit C, Scope of Services, and Exhibit D, Rate
Schedule, attached hereto and incorporated herein by reference, so long as services are rendered
satisfactorily and in accordance with the Agreement.
2
c. 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.
d. The Department may withhold reimbursement if Contractor has failed to comply with any part of
the Agreement, including the Financial Management requirements, program objectives, contractual
terms, or reporting requirements. In the event of forfeiture of reimbursement, Contractor may
appeal such circumstance in writing to the Director of Human Services. The decision of the Director
of Human Services shall be final.
5. Financial Management
At all times from the effective date of the Agreement until completion of the Agreement, Contractor shall
comply with the administrative requirements, cost principles and other requirements set forth in the
Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds
expended under this Agreement must conform to the Single Audit Act of 1984 and OMG Circular A-133.
6. Payment Method
Unless otherwise provided in Exhibit B, Contractor's Proposal, Exhibit C, Scope of Services, and Exhibit D,
Rate Schedule:
a. If services are funded through Core Services, Contractor agrees to accept reimbursement
through ACH direct deposit one time per month.
b. If Contractor is not currently set up with the State of Colorado to accept direct deposit,
Contractor agrees to complete and submit a State of Colorado direct deposit enrollment form, which
will be provided by the Department, with a voided check. Failure to complete and submit this form
and voided check in a timely and accurate manner may result in a delay of payment.
c. Contractor agrees to accept payment through county warrant when funding source does not
allow for direct deposit.
7. Compliance with Applicable Laws
a. At all times during the performance of this Agreement, Contractor will strictly adhere to all
applicable Federal and State laws, order, and applicable standards, regulations, interpretations
and/or guidelines issued pursuant thereto. This includes protection of the confidentiality of all
applicant/recipient records, papers, documents, tapes and any other materials that have been or may
hereafter be established which relate to the Agreement. Contractor shall abide by all applicable laws
and regulations, including, but not limited to the following:
- Title VI of the Civil Rights Act of 1964, 42 U.S.C. Sections 2000d-1 Title VI of the Civil
Rights Act of 1964, 42 U.S.C. Sections 2000d-1 et. seq. and its implementing regulation, 45
C.F.R. Part 80 et. seq.; and
- all provisions of the Civil Rights Act of 1986 so that no person shall, on the grounds of
race, creed, color, sex, or national origin, be excluded from participation in, be denied the
benefits of, or be otherwise subjected to discrimination under the approved Agreement.
- Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. Section 794, and its
implementing regulations, 45 C.F.R. Part 84; and
3
- the Age Discrimination Act of 1975, 42 U.S.C. Section 6101 et. seq. and its
implementation regulations, 45 C.F.R. Part 91; and
- Title VII of the Civil Rights Act of 1964; and
- the Age Discrimination in Employment Act of 1967; and
- the Equal Pay Act of 1963; and
- the Education Amendments of 1972; and
- Immigration Reform and Control Act of 1986, P.L. 99-603, 42 C.F.R. Part 2; and
- all regulations applicable to these laws prohibiting discrimination because of race, color,
national origin, sex, religion, and handicap, including Acquired Immune Deficiency Syndrome
(AIDS) or AIDS related conditions covered under Section 504 of the Rehabilitation Act of
1973, as amended, cited above. If necessary, Contractor and the Department will resist in
judicial proceedings any efforts to obtain access to client records except as permitted by 42
C.F.R. Part 2. 45 C.F.R. Part 74, Appendix G 9, which requires that affirmative steps be taken
to assure that small and minority businesses are utilized, when possible, as sources of
supplies, equipment, construction and services. This assurance is given in consideration of
and for the purpose of obtaining any all Federal and/or State financial assistance.
- Colorado Revised Statute (C.R.S.) 26-6-104, requiring criminal background record checks
for all employees, contractors and sub -contractors.
b. Contractor is further charged with the knowledge that any person who feels that s/he has been
discriminated against has the right to file a complaint either with the Colorado Department of Human
Services or with the United States Department of Health and Human Services, Office for Civil Rights.
c. Contractor assures that it will fully comply with all other applicable Federal and State laws which
may govern the ability of the Department to comply with the relevant funding requirements.
Contractor understands the source of funds to be accessed under the Agreement is determined by
the Department.
d. Contractor assures and certifies that it and its principals:
- Are not presently debarred, suspended, proposed for debarment, declared ineligible, or
voluntarily excluded from covered transaction by a Federal or State department or agency;
and
- have not, within a three-year period preceding this Agreement, been convicted of or
had a civil judgment rendered against them for commission of fraud or criminal offense in
connection with obtaining, attempting to obtain, or performing a public (Federal, State or
Local) transaction or contract under public transaction; violation of federal or state antitrust
statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction
of records, making false statements, or receiving stolen property; and
- are not presently indicted for or otherwise criminally or civilly charged by a government
entity (federal, state or local) with commission of any of the offenses enumerated in this
certification; and
- have not, within a three-year period preceding this Agreement, had one or more public
transactions (federal, state, or local) terminated for cause or default.
4
e. 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 the Department 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. 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 the
Department, 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., the
Department, may terminate this Agreement for breach, and if so terminated, Contractor shall be liable
for actual and consequential damages.
f. 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-
76.5-1O1, 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.
8. Compliance with Child and Family Services Review
The Child and Family Services Review (CFSR) examines child welfare service outcomes in three areas;
Safety, Permanency and Well Being of families. For each outcome, data and performance indicators
measure each state's performance according to national standards and monitor progress over time.
Following the review, a Program Improvement Plan (PIP) will be implemented for the state to enhance
services to families.
Contractor agrees to continually strive for positive outcomes in the areas of Safety, Permanency and Well
Being. Contractor will ensure that any employee or subcontractor of Contractor providing services under
this Agreement will work towards positive outcomes in the aforementioned three areas as outlined under
5
the Child and Family Services Review (CFSR) and will address the aforementioned three areas when
completing monthly reports as required by Paragraph 3(d) of this Agreement.
9. Insurance Requirements
Contractor and the Department agree that Weld County, the Board of County Commissioners of Weld
County, its officers and employees, shall not be held liable for injuries or damages caused by any negligent
acts or omissions of the Contractor, it subcontractor, or their employees, volunteers, or agents while
performing duties described in this Agreement. Contractor shall indemnify, defend and hold harmless
Weld County, the Board of County Commissioners of Weld County, its employees, volunteers and agents.
Contractor shall provide the liability insurances (including professional liability insurances where
necessary) and worker's compensation insurances for all its employees, volunteers, and agents engaged in
the performance of this Agreement which are required under Weld County's Request for Proposal, and
required by the Colorado Worker's Compensation Act. Contractor shall provide the Department with the
acceptable evidence that such coverage is in effect within seven (7) days of the date of this Agreement.
At a minimum, Contractor shall procure, either personally or through its employer as applicable to the
Contractor's business, at its own expense, and maintain for the duration of the work, insurance coverage
listed in this agreement. The Board of County Commissioners of Weld County and its Officers/Employees
shall be named as additional insured.
a. General Requirements: Contractors must secure, at or before the time of execution of
any agreement or commencement of any work, the following insurance covering all operations,
goods or services provided pursuant to this request. Contractors shall keep the required insurance
coverage in force at all times during the term of the Agreement, or any extension thereof, and
during any warranty period. The required insurance shall be underwritten by an insurer licensed
to do business in Colorado and rated by A.M. Best Company as "A"VIII or better. Each policy shall
contain a valid provision or endorsement stating "Should any of the above -described policies by
canceled or should any coverage be reduced before the expiration date thereof, the issuing
company shall send written notice to the Weld County Director of General Services by certified
mail, return receipt requested. Such written notice shall be sent thirty (30) days prior to such
cancellation or reduction unless due to non-payment of premiums for which notice shall be sent
ten (10) days prior. If any policy is in excess of a deductible or self -insured retention, the
Department must be notified by the Contractor. Contractor shall be responsible for the payment
of any deductible or self -insured retention. The Department reserves the right to require
Contractor to provide a bond, at no cost to the Department, in the amount of the deductible or
self -insured retention to guarantee payment of claims. The insurance coverages specified in this
Agreement are the minimum requirements, and these requirements do not decrease or limit the
liability of Contractor. Contractor shall maintain, at its own expense, any additional kinds or
amounts of insurance that it may deem necessary to cover its obligations and liabilities under this
Agreement.
b. Types of Insurance: Contractor shall obtain, and maintain at all times during the term of
any Agreement, insurance in the following kinds and amounts:
i.Workers' Compensation Insurance as required by state statute, and Employer's Liability
Insurance covering all of Contractor's employees acting within the course and scope of
their employment. If Contractor is an Independent Contractor, as defined by the
Colorado Worker's Compensation Act, this requirement shall not apply. Contractor must
submit to the Department a Declaration of Independent Contractor Status Form prior to
the start of this agreement.
6
ii.Commercial General Liability Insurance written on ISO occurrence form CG 00 01 10/93
or equivalent, covering premises operations, fire damage, independent Contractors,
products and completed operations, blanket contractual liability, personal injury, and
advertising liability with minimum limits as follows:
- $1,000,000 each occurrence;
- $2,000,000 general aggregate;
- $50,000 any one fire; and
- $500,000 errors and omissions.
iii.Automobile Liability: Contractor shall maintain limits of $1,000,000 for bodily injury per
person, $1,000,000 for bodily injury for each accident, and $1,000,000 for property
damage applicable to all vehicles operating both on County property and elsewhere.
iv.Additional Provisions: Policies for all general liability, excess/umbrella liability, liquor
liability and pollution liability must provide the following:
If any aggregate limit is reduced by twenty-five percent (25%) or more
by paid or reserved claims, Contractor shall notify the Department within ten
(10) days and reinstate the aggregates required;
Unlimited defense costs in excess of policy limits;
Contractual liability covering the indemnification provisions of this
Agreement;
A severability of interests provision;
Waiver of exclusion for lawsuits by one insured against another;
A provision that coverage is primary; and
A provision that coverage is non-contributory with other coverage or
self-insurance provided by the Department.
v.For all general liability, excess/umbrella liability, liquor liability, pollution liability and
professional liability policies, if the policy is a claims -made policy, the retroactive date
must be on or before the contract date or the first date when any goods or services were
provided to the Department, whichever is earlier.
c. Contractors shall secure and deliver to County's Risk Administrator ("Administrator") at
or before the time of execution of this Agreement, and shall keep in force at all times during the
term of the Agreement as the same may be extended as herein provided, a commercial general
liability insurance policy, including public liability and property damage, in form and company
acceptable to and approved by said Administrator, covering all operations hereunder set forth in
the related Bid or Request for Proposal.
d. Proof of Insurance: Contractor shall provide a copy of this information to its insurance
agent or broker and shall have its agent or broker provide proof of Contractor's required
insurance. The Department reserves the right to require Contractor to provide a certificate of
insurance, a policy, or other proof of insurance as required by the County's Risk Administrator in
his sole discretion.
e. Additional Insureds: For general liability, excess/umbrella liability, pollution legal liability,
liquor liability, and inland marine, Contractor's insurer shall name County as an additional insured.
f. Waiver of Subrogation: For all coverages, Contractor's insurer shall waive subrogation
rights against County.
B. Subcontractors: All subcontractors, independent contractors, sub -vendors, suppliers or
other entities providing goods or services required by this Agreement shall be subject to all of the
requirements herein and shall procure and maintain the same coverages required of Contractor.
Contractor shall include all such subcontractors, independent contractors, sub -vendors, suppliers
or other entities as insureds under its policies or shall ensure that all subcontractors maintain the
required coverages. Contractor agrees to provide proof of insurance for all such subcontractors,
independent contractors, sub -vendors, suppliers or other entities upon request by the
Department.
A provider of Professional Services (as defined in the Bid or RFP) shall provide the following
coverage:
Professional Liability: Contractor shall maintain limits of $1,000,000 for each claim, and
$2,000,000 aggregate limit for all claims.
10. Certification
Contractor certifies that, at the time of entering into this Agreement, it has currently in effect all
necessary licenses, approvals, insurance, etc., required to properly provide the services and/or supplies
covered by this Agreement. Copies of all necessary licenses shall be provided to the Department by the
Contractor prior to the start of any Agreement.
11. Training
Contractor may be required to attend training at the request of the Department specific to services
provided under this Agreement. The Department will not compensate the Contractor for said training in
the form of registration fees, time spent traveling to and from training, attending the training or any other
associated costs unless otherwise agreed to by the Department.
12. Subpoenas
Contractor will, on behalf of its employees and/or officers, accept any subpoena for testimony from the
Weld County Attorney's Office by e-mail and will return a waiver of services within 72 business hours. For
this purpose, Contractor will designate an e-mail address prior to the start of this Agreement. If the
Contractor receives a subpoena via e-mail but will only accept personal service, the Contractor will
contact the Weld County Attorney's Office immediately at 970-336-7235, and advise that the subpoena
must be personally served.
13. Monitoring and Evaluation
Contractor and the Department agree that monitoring and evaluation of the performance of this
Agreement shall be conducted by the Contractor and the Department. The results of the monitoring and
evaluation shall be provided to the Board of Weld County Commissioners, the Department and the
Contractor.
Contractor will collaborate in a timely manner with the Department to resolve issues pertaining to service
delivery, service quality, documentation, and invoicing during referral period and after services have
concluded. The Contractor will require clients sign releases of information. Contractor understands that
the Department will not reimburse for services rendered to Department clients until releases of
information are obtained.
Contractor shall permit the Department, and any other duly authorized agent or governmental agency, to
monitor all activities conducted by the Contractor pursuant to the terms of this Agreement. The
monitoring agency may, if in its sole discretion deems necessary or appropriate, have access to any
program data, special analyses, on -site checking, formal audit examinations, or any other reasonable
8
procedures for purposes of monitoring. All such monitoring shall be performed in a manner that will not
unduly interfere with the work conducted under this Agreement.
14. Modification of Agreement
All modifications to this Agreement shall be in writing and signed by both parties.
15. Remedies
The Director of Human Services or designee may exercise the following remedial actions should s/he find
the Contractor substantially failed to satisfy the scope of work found in this Agreement. Substantial
failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by
the Contractor. These remedial actions are as follows:
- Withhold payment to the Contractor until the necessary services or corrections in
performance are satisfactorily completed.
- Deny payment or recover reimbursement for those services or deliverables, which have
not been performed and which due to circumstances caused by the Contractor cannot be
performed or if performed would be of no value to the Department. Denial of the amount
of payment shall be reasonably related to the amount of work or deliverables lost to the
Department.
- Incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation
shall be recovered from Contractor by deduction from subsequent payments under this
Agreement or other agreements between the Department and Contractor, or by the
Department as a debt due to the Department or otherwise as provided by law.
16. Representatives
For the purpose of this Agreement, the individuals identified below are hereby designated representatives
of the respective parties. Either party may from time to time designate in writing a new or substitute
representative(s).
For Department: For Contractor:
Heather Walker, Child Welfare Division Head Jill Johnson, Administrative Consultant
17. Notice
All notices required to be given by the parties hereunder shall be given by certified or registered mail to
the individuals at the addresses set forth below. Either party may from time to time designate in writing a
substitute person(s) or address to whom such notices shall be sent.
For Department:
Jamie Ulrich, Director
P.O. Box A
Greeley, CO 80632
(970) 400-6581
18. Litigation
For Contractor:
Jill Johnson, Administrative Consultant
P.O. Box 272595
Fort Collins, CO 80527
(970) 290-3094
Contractor shall promptly notify the Department in the event that Contractor learns of any actual
litigation in which it is a party defendant in a case that involves services provided under this Agreement.
9
Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading
which has been filed in any Federal or State court or administrative agency, shall deliver copies of such
document(s) to the Director of Human Services. The term "litigation" includes an assignment for the
benefit of creditors, and filings of bankruptcy, reorganization and/or foreclosure.
19. Termination
This Agreement may be terminated at any time by either party giving thirty (30) days written notice to the
individuals identified in paragraph 17. No portion of this Agreement shall be deemed to create an
obligation on the part of the County of Weld, State of Colorado, to expend funds not otherwise
appropriated in each succeeding year, as this Agreement is subject to the availability of funding.
Therefore, the Department may terminate this Agreement at any time if the source of funding for the
services made available to the Contractor is no longer available to the Department, or for any other
reason. Contractor reserves the right to suspend services to clients if funding is no longer available.
20. No Third -Party Beneficiary Enforcement
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.
21. 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 of §§24-10-101 et. seq., as applicable now or hereafter amended.
22. Partial Invalidity of Agreement
If any section, subsection, paragraph, sentence, clause, or phrase of this Agreement is for any reason held
or decided to be unconstitutional, such decision shall not affect the validity of the remaining portions.
The parties hereto declare that they would have entered into this Agreement and each and every section,
subsection, paragraph, sentence, clause, and phrase thereof irrespective of the fact that any one or more
sections, subsections, paragraphs, sentences, clauses, or phrases might be declared to be unconstitutional
or invalid.
23. Improprieties/Conflict of Interest
No officer, member or employee of Weld County and no member of their governing bodies shall have any
pecuniary interest, direct or indirect, in the approved Agreement or the proceeds thereof.
The Appearance of Conflict of Interest applies to the relationship of a Contractor with the Department
when the Contractor also maintains a relationship with a third party and the two relationships are in
opposition. In order to create the appearance of a conflict of interest, it is not necessary for the
Contractor to gain from knowledge of these opposing interests. It is only necessary that the Contractor
know that the two relationships are in opposition. During the term of the Agreement, Contractor shall
not enter into any third -party relationship that gives the appearance of creating a conflict of interest.
Upon learning of an existing appearance of a conflict of interest situation, Contractor shall submit to the
Department, a full disclosure statement setting forth the details that create the appearance of a conflict
10
of interest. Failure to promptly submit a disclosure statement required by this paragraph shall constitute
grounds for the Department's termination, for cause, of its Agreement with the Contractor.
A conflict of interest or appearance of a conflict of interest may also apply to personal relationships
between providers and clients. If a provider has a personal relationship with a client to whom the
Contractor may provide services for, the Contractor must disclose that relationship to the Department.
Contractor certifies that Federal appropriated funds have not been paid or will be paid, by or on behalf of
Contractor, to any person for influencing or attempting to influence an officer or employee of an agency,
a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in
connection with the awarding of any Federal contract, the making of any Federal grant, the making of any
Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal,
amendment, or modification of an Federal contract, loan, grant, or cooperative agreement.
24. Storage, Availability and Retention of Records
Contractor agrees that authorized local, Federal, and State auditors and representatives shall, during
business hours, have access to inspect and copy records, and shall be allowed to monitor and review
through on -site visits, all activities related to this Agreement, supported with funds under this Agreement,
to ensure compliance with the terms of this Agreement. Contracting parties agree that monitoring and
evaluation of the performance of the Agreement shall be conducted by appropriate funding sources. The
results of the monitoring and evaluation activities shall be provided to the appropriate and interested
parties.
All such records, documents, communications, and other materials created pursuant or related to this
Agreement shall be maintained by the Contractor in a central location and shall be made available to the
Department upon its request, for a period of seven (7) years from the date of final payment under this
Agreement, or for such further period as may be necessary to resolve any matters which may be pending,
or until an audit has been completed with the following qualifications: If an audit by or on behalf of the
Federal and/or State government has begun but is not completed at the end of the seven (7) year period,
or if audit findings have not been resolved after a seven (7) period, the materials shall be retained until
the resolution of the audit finding.
25. Confidentiality of Records
Contractor shall protect the confidentiality of all applicant records and other materials that are
maintained in accordance with this Agreement except for purposes directly connected with the
administration of Child Protection. No information about or obtained from any applicant/recipient in
possession of Contractor shall be disclosed in a form identifiable with the applicant/recipient or a minor's
parent or guardian unless in accordance with the Contractor's written policy governing access to,
duplication and dissemination of, all such information, in any form, including social networks. Contractor
shall advise its employees, agents, and subcontractor, if any, that they are subject to these confidentiality
requirements.
Contractor shall provide its employees, agents, and subcontractors, if any, with a copy or written
explanation of these confidentiality requirements before access to confidential data is permitted.
Contractor shall have its employees, agents, and subcontractors, if any, sign a written confidentiality
agreement and shall provide a copy of such agreement to the Department, if requested.
26. Proprietary Information
Proprietary information for the purposes of this Agreement is information relating to a party's research,
development, trade secrets, business affairs, internal operations and management procedures and those
11
of its customers, clients or affiliates, but does not include information (1) lawfully obtained from third
parties, (2) that which is in the public domain, or (3) that which is developed independently. Neither
party shall use or disclose directly or indirectly without prior written authorization any proprietary
information concerning the other party obtained as a result of this Agreement. Any proprietary
information removed from the Department's site by the Contractor in the course of providing services
under this Agreement will be accorded at least the same precautions as are employed by the Contractor
for similar information in the course of its own business.
27. Independence of Contractor: Not an Employee of Weld County
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. Contractor shall not have authorization, express or implied, to bind County to any
agreement, liability or understanding, except as expressly set forth in this Agreement. Contractor shall
have the following responsibilities with regard to workers' compensation and unemployment
compensation insurance matters: (a) provide and keep in force workers' compensation and
unemployment compensation insurance in the amounts required by law, and as set forth in Exhibit A,
provide proof thereof when requested to do so by County.
28. Entire Agreement
This Agreement, together with all attachments hereto, constitutes the entire understanding between the
parties with respect to the subject matter hereof, and may not be changed or modified except as state in
Paragraph 14 herein. This Agreement shall be binding upon the parties hereto, their successors, heirs,
legal representatives, and assigns. The Contractor and the Department may not assign any of its rights or
obligations hereunder without the prior consent of both parties.
29. Agreement Nonexclusive
This Agreement does not guarantee any work nor does it create an exclusive agreement for services.
30. Warranty
The Contractor warrants that services performed under this Agreement will be performed in a manner
consistent with the professional standards governing such services and the provisions of this Agreement.
The Contractor shall faithfully perform the work in accordance with the standards of care, skill, training,
diligence and judgment provided by highly competent individuals and entities that perform services of a
similar nature to those described in this Agreement including Exhibits A, B, C, and D.
31. Acceptance of Services Not a Waiver
Upon completion of the work, the Contractor shall submit to the Department originals of all tests and
results, reports, etc., generated during completion of this work. Acceptance by the Department of reports
and incidental material(s) furnished under this Agreement shall not in any way relieve the Contractor of
responsibility for the quality and accuracy of the services. In no event shall any action by the Department
12
hereunder constitute or be construed to be a waiver by the Department of any breach of covenant or
default which may then exist on the part of the Contractor, and the Department's action or inaction when
any such breach or default shall exist shall not impair or prejudice any right or remedy available to the
Department with respect to such breach or default; and no assent, expressed or implied, to any breach of
any one or more covenants, provisions or conditions of the Agreement shall be deemed or taken to be a
waiver of any other breach. Acceptance by the Department of, or payment for, any services performed
under this Agreement shall not be construed as a waiver of any of the Department's rights under this
Agreement or under the law generally.
32. Employee Financial Interest/Conflict of Interest. C.R.S. §§24-18-201 et seq. and §24-50-507
The signatories to this Agreement aver 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. The Contractor has no interest and shall not acquire any interest direct or indirect, which
would in any manner or degree with the performance of the Contractor's services and the Contractor,
shall not employ any person having such known interests. During the term of this Agreement, the
Contractor shall not engage in any in any business or personal activities or practices or maintain any
relationships which actually conflicts with or in any way appear to conflict with the full performance of its
obligations under this Agreement. Failure by the Contractor to ensure compliance with this provision may
result, in the Department's sole discretion, in immediate termination of this Agreement. No employee of
the Contractor nor any member of the Contractor's family shall serve on a County Board, committee or
hold any such position which either by rule, practice or action nominates, recommends, supervises
Contractor's operations, or authorizes funding to the Contractor.
33. 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.
34. 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.
35. Subcontractors
Contractor acknowledges that the Department 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 the Department's prior written consent, which may
be withheld in the Department's sole discretion.
36. Attorney's Fees/Legal Costs
In the event of a dispute between the Department and Contractor, concerning this Agreement, the parties
agree that each party shall be responsible for the payment of attorney fees and/or legal costs incurred by
or on its own behalf.
37. Ownership
All work and information obtained by Contractor under this Agreement or individual work order shall
become or remain (as applicable), the property of the Department. In addition, all reports, documents,
13
data, plans, drawings, records and computer files generated by Contractor in relation to this Agreement
and all reports, test results and all other tangible materials obtained and/or produced in connection with
the performance of this Agreement, whether or not such materials are in completed form, shall at all times
be considered the property of the Department. Contractor shall not make use of such material for purposes
other than in connection with this Agreement without prior written approval of the Department.
38. 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.
39. 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.
IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and
year first above written.
COUNTY:
ATTEST: i�rz n) �I• "Cf+�6ti
�
BOARD OF COUNTY COMMISSIONERS
Weld County Clerk to the Board WELD COUNTY, COLORADO
DepuT tlerktothe Board
14
Mike Freeman, Chair
MAY 1 12020
CONTRACTOR:
Tindall, Bartels & Associates
P.O. Box 272595
Fort Collins, CO 80527
(970) 290-3094
By:
Jill JAI „���i(w 3, 2020)
Jill Johnson, Administrative Consultant
Date: Apr 9, 2020
2 2o-4377
EXHIBIT A
WELD COUNTY'S REQUEST FOR PROPOSAL
(Weld County's Request for Proposal is incorporated into this agreement by reference and will be provided upon
request to the Department.)
This page intentionally left blank.
Tindall, Bartels
& Associates
Forensic Evaluations. Consulting & Training -
970 -231-9611
Denver, Fort Collins & Greeley Offices
www.tindall-bartels.org
EXHIBIT B
CONTRACTOR'S RESPONSE TO REQUEST FOR PROPOSAL
Services Offered
Tindall, Bartels & Associates specializes in offering mental health services to meet the
specific needs of the legal community. We are prepared to provide professional and
comprehensive eve nations in a timeframe that fits your needs, including quick turn-
around. We understand that reliable recommendations rendered by accredited
professionals can be invaluable to the final outcome of your case.
Our team consists of licensed psychologists who are full -operating Sex Offender
Management Board providers bringing their experience and expertise to evaluations for
individuals who have been accused of a variety of offenses. We have extensive
experience in offering court room testimony and are committed to being responsive to the
individual needs of your client and your case.
We offer the following types of evaluations and services:
• Full Psychological Batteries
• Mental Health Screens
• Cognitive Evaluations
• Sex Offense Specific Evaluations, Psychosexual Evaluations, Matrix Evaluations
• Domestic Violence Evaluations
Child Contact Assessments
• Competency, Insanity, and Trauma Evaluations
Please see our website (tindall-bartels.org) for complete descriptions of our services.
We also offer brief or extended CLE accredited presentations covering Assessment
Techniques (any type), Sex Offender issues, The Matrix, Vicarious Trauma, and can also
create a presentation to fit your specific educational need.
If you have any questions about our services, feel free to contact our offices. We look
forward to working with you.
ATTACHMENT B
WELD COUNTY DEPARTMENT OF HUMAN SERVICES - PROVIDER INFORMATION FORM (PIF)
Please type your information using the form fields (boxes) below. You can press the Tab key to move from field to field.
Agency Information
Agecy Na
me: me: Tindall, Bartels & Associates, LLC Trails Provider ID if known):
a
Primary Contact Full Name: Jill Johnson Title: Administrative Consultant
Primary Phone Number(10-digit): (970}290-3094'
Primary Contact Email: jill@tindall-bartels.com
Ext.:
Fax Number to -di it : (970)797-1990
t �)
Web Address: tindall-bartels.org
Agency Location Address (Street, city, state, zip):
1122 9th Street, Greeley CO 80631
ty p
Agency Mailing Address (Street, city, state, zip):
P.O. Box 272595, Fort Collins CO 80527
YY P
Agency Type (pick one):
Private El Private Non -Profit
Private for Profit
DOHS service referrals should be sent to whom in your organization:
Referral Contact Name: Angi Oestreich Title: Scheduling Coordinator
Referral Phone Number (970)231-9611
(lo -digit):
Email: scheduling@tindall-bartels.com
Billing Contact
Billie Contact Name: Pam McCulloch Title: Billing Coordinator
g
Billing Phone Number (10 -digit):
858)945-5229
g
Ext.:
Email: billing@tindall-bartels.com
IS Si
••
CERTIFICATION
in • ■ 0111•1•110111=flaslialallintlailll..�
■
I certify that the services proposed for intended use by the Weld County Department of Human Services will meet all the
specifications it has so indicated in this bid form. I further affirm intention to enter into an agreement with Weld County, on
behalf of the Weld County Department of Human Services, and comply with all requirements of the contract, if awarded.
The Board of Weld County Commissioners reserve the right to reject any or all bids, to waive any informality in the bids, and
to accept the bid, or part of a bid, that, in the opinion of the Board, is in the best interests of the Board and of the County of
Weld, State of Colorado. The Board of Weld County Commissioners shall give preference to resident Weld County bidders in
all cases where the bids are competitive in price and quality.
Authorized Rep. Full Name: Jill Johnson
Title: Administrative Consultant
Authorized Rep. Email: uu11@Bedell-bartels.com Phone: (970)290-3094
Ext.:
Authorized Rep. Address: 1122 9th Street, Greeley CO 80631
Signature of Authorized Rep.:
IIIIII111111 S • s • •
01/24/2020
Date:
a IS a MI IN SI MEMO III MI
MI I=M II MI
■
■
a
I
I
■
■
I
I
■
■
■
I
I
• • EMI • ■ Mal • s • s
REV. DEC 2019
ATTACHMENT C - PROPOSAL TEMPLATE
Please type your answers in the boxes below.
SECTION 1 Provider and Program Area Information
Bidder's Legal
Name:
Program
Area:
Tindall, Bartels & Associates, LLC
Sexual Abuse Treatment
Program Areas are listed in column 1 of the table located in Item XI of the
Request for Proposal starting on page 13.
Number of services offered on this Exhibit C (max 5):
You may complete another Exhibit C if you have more than S.
4
Service
Name:
#1
SECTION
2
—
Service
Name(s) and
Information
Offense
Specific
Evaluations
2.1a
Modalities,
curriculum,
tools
used
in delivery
of
service (DO
NOT
list company
history;
DO use bullet
points):
In -person
evaluations
using
psychological
testing
if
needed.
2.1b
Anticipated
frequency
of
service
per week
(i.e. 4 hours/week):
Tindall,
Bartels
& Associates
have 3 office
locations and
3 clinicians,
so are able
to
do all
evaluations within
a
reasonable
amount
of time, and some on short -notice. The
hours depend
on the extent of the evaluation.
2.1c
Anticipated
duration
of service (i.e. 3-4 months):
Dependent
on
the
extent
of evaluation.
Typically
completed
within
90 days.
2.1d
Three
(3), or more, specific
goals
of the
service (DO
use bullet
points):
Adult
SOMB/DVOMB
Standards:
®
The
need
additional
purpose
for
treatment,
needs
of
a
the
mental
determine
client
health
may
sex
what
have.
offense
type
of
-specific
treatment
evaluation
is needed,
(hereafter
and
identify
evaluation)
the
risk
to
assess a client's
and any
is
level
•
Treatment considerations
should
be
based on
the
conclusions
and
recommendations
of
the
evaluation.
While
the
evaluation
provides
valuable
information
and recommendations,
it
should
be viewed
as
fluid.
As new
should
information
be
tailored
emerges,
to address
those
or risk
level
changes.
changes
within
the course of
treatment, a client's
treatment
•
the
functioning,
and
Because
interaction
behavioral
of the
and
importance
monitoring,
between
offending
the
of
each
client's
behaviors.
the
client
initial
mental
shall
information
receive
health,
to
a thorough
social/systemic
subsequent
assessment
sentencing,
and
functioning,
family
supervision,
evaluation
that
and environmental
treatment,
examines
• Sex
neuropsychological
comprehensive
offense
-specific
and
evaluations.
evaluations
factual
are
manner,
Evaluators
not
regardless
intended
have
of
an
to
the
replace
ethical
client's
more
responsibility
status
comprehensive
within
to
the
conduct
criminal
psychological
evaluations
justice
or
in
system.
a
•
treatment,
Evaluations
responsivity
client's
likelihood
management,
recommending
of each
to
individual
sexually
and
sex
reoffend.
offense
monitoring
client
-specific
and
interventions
that
treatment
minimize
that
that
should
are
appropriate
suggest
the
use
for
of
the
research
risk
level,
informed
needs,
and
• Consequently,
victims
in making
evaluators
recommendations
will
prioritize
that
the
are
physical
appropriate
and
psychological
to the
assessed
safety
risk
of
and
victims
needs
and
of
each
potential
client.
•
upon
Various stakeholders,
evaluations
including
to make
informed
lawyers,
decisions
judges,
at
supervising
multiple
officers,
points
in
time.
treatment
providers
and others,
rely
•
treatment,
Evaluators
should
and
should
not
assume
attempt
that
to
readers
minimize
possess
overemphasis
clinical
training or
on any single
expertise
test
in
or aspect
mental
of
the
health
assessment.
•
in
recommendations
Evaluation(s)
offender
Section
criminogenic
4.08
shall
"Required
be conducted
needs,
regarding
Minimum
offender
offender
to
identify
Sources
responsivity
treatment.
the
of
Information."
following
to
treatment,
factors:
These
risk
and
factors
of
other
re -offense
treatment
shall
and/or
assist in
issues
determining
further
as
identified
abuse,
REV. NOV 2019
1
ATTACHMENT C - PROPOSAL TEMPLATE
• Evaluation(s) shall result in an initial offender Treatment Plan with the understanding that assessment is
an ongoing process, which may necessitate changes to the plan.
• Evaluation(s) shall direct initial placement of the offender into the appropriate level and intensity of
treatment as identified in Standard 5.06.
• Identification of individual criminogenic factors/needs (Reference Appendix E, Section IV) - Identification
of strategies for managing criminogenic factors/needs and potential destabilizing factors - Identification of
offender strengths (e.g., pro -social support, employment, education) - Initial recommendations for
treatment planning - Initial recommendations for offender monitoring related to community and victim
safety, if applicable - Assessment of offender responsivity (Reference Appendix E, Section VI) - Assessment
of offender accountability (Reference Appendix E, Section I) - Assessment of amenability for treatment is
defined as: The ability to comprehend treatment concepts The physical and mental ability to function in a
treatment setting —
• Juvenile SOMB Standards:
• Evaluations are conducted to identify levels of risk and specific risk factors that require attention in
treatment and supervision, and to assist the court in determining the most appropriate sentence for
juveniles. Due to the importance of the information to subsequent sentencing, supervision, treatment and
behavioral monitoring, each juvenile who has committed a sexual offense shall receive a thorough
assessment and evaluation that examines the interaction of the juvenile's mental health, social/systemic
functioning, family and environmental functioning, and offending behaviors.
• A thorough review of relevant prior treatment and supervision information can aid in the planning of
treatment needs for the client and ensure continuity of care. To this end, it is imperative that the
Evaluator make every reasonable effort to identify and obtain past records to determine what treatment
may have been completed, what components of treatment need additional focus, and what components
of treatment have not yet been completed.
• Sex offense specific evaluations are not intended to supplant more comprehensive psychological or
neuropsychological evaluations. Evaluators have an ethical responsibility to conduct evaluations in a
comprehensive and factual manner regardless of the juvenile's status within the criminal justice system.
• The evaluation of juveniles who have committed sexual offenses shall be comprehensive.
• Recommendations for intervention shall be included in the summary and the evaluation shall be provided
in written form to the referring agent.
• The evaluation of juveniles who have committed sexual offenses has the following purposes: A. To assess
overall risk to the community; B. To provide protection for victims and potential victims; C. To provide
written clinical assessment of a juvenile's strengths, risks and needs; D. To identify and document
treatment and developmental/cognitive needs; E. Prior treatment involvement; F. To identify individual
differences, potential barriers to treatment, and static and dynamic risk factors; G. To make
recommendations for the management and supervision of the juvenile; H. To provide information which
can help identify the type and intensity of community based treatment, or the need for a more restrictive
setting.
2.1e Three (3), or more, specific outcomes of service:
• Answer identified referral questions
• Appropriately assess client's strengths, risks and needs
• To make recommendations for the management and supervision of the juvenile
• Timely evaluation report
2.1f Target population of the service, including age and gender:
REV. NOV 2019 2
ATTACHMENT C - PROPOSAL TEMPLATE
Tindall, Bartels & Associates conduct evaluations for all ages, all genders, all races, including DD/ID, LGBTQ.
2.1g Languages service is available in (please list proficiency and if interpreter services are available):
Possibility of Spanish interpretation if not available from the referral source.
2.1h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part:
No
Service #2
Name:
2.2a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points):
ID/DD Offense Specific Evaluations
In -person evaluations using psychological testing if needed.
2.2b Anticipated frequency of service per week (i.e. 4 hours/week):
Determined per case.
2.2c Anticipated duration of service (i.e. 3-4 months):
Dependent on Client. Typically completed within 90 days.
2.2d Three
3 or more, specific goals of the service (DO use bullet points):
Adult Standards:
The purpose of a mental health sex offense -specific evaluation (hereafter evaluation) is to assess a client's
n eed for treatment, determine what type of treatment is needed, and identify the risk level and any
additional needs the client may have.
Treatment considerations should be based on the conclusions and recommendations of the evaluation.
While the evaluation provides valuable information and recommendations, it should be viewed as fluid. As
n ew information emerges, or risk level changes within the course of treatment, a client's treatment should
be tailored to address those changes.
• Because of the importance of the initial information to subsequent sentencing, supervision, treatment,
and behavioral monitoring, each client shall receive a thorough assessment and evaluation that examines
the interaction between the client's mental health, social/systemic functioning, family and environmental
functioning, and offending behaviors.
• Sex offense -specific evaluations are not intended to replace more comprehensive psychological or
n europsychological evaluations. Evaluators have an ethical responsibility to conduct evaluations in a
comprehensive and factual manner, regardless of the client's status within the criminal justice system.
• Evaluations recommending sex offense -specific treatment should suggest the use of research informed
treatment, management, and monitoring interventions that are appropriate for the risk level, needs, and
responsivity of each individual client and that minimize that
client's likelihood to sexually reoffend.
• Consequently, evaluators will prioritize the physical and psychological safety of victims and potential
victims in making recommendations that are appropriate to the assessed risk and needs of each client.
• Various stakeholders, including lawyers, judges, supervising officers, treatment providers and others, rely
u pon evaluations to make informed decisions at multiple points in time.
• Evaluators should not assume that readers possess clinical training or expertise in mental health
treatment, and should attempt to minimize overemphasis on any single test or aspect of the assessment.
• Conducted per Standards/Guidelines specific to ID/DD clients.
Juvenile Standards:
• Evaluations are conducted to identify levels of risk and specific risk factors that require attention in
treatment and supervision, and to assist the court in determining the most appropriate sentence for
juveniles. Due to the importance of the information to subsequent sentencing, supervision, treatment and
behavioral monitoring, each juvenile who has committed a sexual offense shall receive a thorough
assessment and evaluation that examines the interaction of the juvenile's mental health, social/systemic
functioning, family and environmental functioning, and offending behaviors.
• A thorough review of relevant prior treatment and supervision information can aid in the planning of
treatment needs for the client and ensure continuity of care. To this end, it is imperative that the
REV. NOV 2019 3
ATTACHMENT C ® PROPOSAL TEMPLATE
Evaluator make every reasonable effort to identify and obtain past records to determine what treatment
may have been completed, what components of treatment need additional focus, and what components
of treatment have not yet been completed.
• Sex offense specific evaluations are not intended to supplant more comprehensive psychological or
neuropsychological evaluations. Evaluators have an ethical responsibility to conduct evaluations in a
comprehensive and factual manner regardless of the juvenile's status within the criminal justice system.
• The evaluation of juveniles who have committed sexual offenses shall be comprehensive.
• Recommendations for intervention shall be included in the summary and the evaluation shall be provided
in written form to the referring agent.
• The evaluation of juveniles who have committed sexual offenses has the following purposes: A. To assess
overall risk to the community; B. To provide protection for victims and potential victims; C. To provide
written clinical assessment of a juvenile's strengths, risks and needs; D. To identify and document
treatment and developmental/cognitive needs; E. Prior treatment involvement; F. To identify individual
differences, potential barriers to treatment, and static and dynamic risk factors; G. To make
recommendations for the management and supervision of the juvenile; H. To provide information which
can help identify the type and intensity of community based treatment, or the need for a more restrictive
setting
• Conducted per Standards/Guidelines specific to ID/DD clients.
2.2e Three (3), or more, specific outcomes of service:
• Answer identified referral questions
• Appropriately assess client's strengths, risks and needs
• To make recommendations for the management and supervision of the juvenile
• Timely evaluation report
2.2f Target population of the service:
Tindall, Bartels & Associates conduct evaluations for all ages, all genders, all races, including DD/ID, LGBTQ.
2.2g Languages service is available in (please list proficiency and if interpreter services are available):
Possibility of Spanish interpretation if not available from the referral source.
2,2h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part:
No
Service #3
Name:
2.3a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points):
Consultation Services
No -refundable engagement fee for consultation services.
2.3b Anticipated frequency of service per week (i.e. 4 hours/week):
Determined per case
2.3c Anticipated duration of service (i.e. 3-4 months):
Determined per case. Typically within 2 weeks of services/intake assessment.
2.3d Three (3), or more, specific goals of the service (DO use bullet points):
• Analyzing a client's case/assessments to help determine a referral source for the most cost-effective, evidence
based, collaborative, trauma -informed approach to create a treatment plan and/or supervision plan.
• Assisting in case review/conceptualization with DHS staff via phone calls, emails and all associated parties.
• Participation in staffing's, family meetings, etc. via phone or in person.
• Providing the department research if requested.
• Reviewing case records and providing informal risk assessments.
• Assisting DHS staff in finding appropriate professionals to help meet treatment needs to mitigate safety concerns
and issues that led to child welfare involvement.
REV. NOV 2019
4
ATTACHMENT C - PROPOSAL TEMPLATE
® Helping to create and appropriate intervention and/or strategy based upon the risk-need-responsivity (RNR).
• Provide expert testimony and preparation of summary reports and recommendations.
2.3e Three (3), or more, specific outcomes of service:
® Answer identified referral questions
® Use expertise in areas of mental health, assessments, testing, and sexual offense treatment to consult with
county.
• Review documents and report and look for provide expert feedback and insights.
2.3f Target population of the service:
Tindall, Bartels & Associates conduct evaluations for all ages, all genders, all races, including DD/ID, LGBTQ.
2.3g Languages service is available in (please list proficiency and if interpreter services are available):
Possibility of Spanish interpretation if not available from the referral source.
2.3h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part:
No
Service #4
Name:
2.4a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points):
LOOK Assessment
Look Assessment
2.4b Anticipated frequency of service per week (i.e. 4 hours/week):
Determined per case.
2.4c Anticipated duration of service (i.e. 3-4 months):
Determined -ler case.
2.4d Three (3), or more, specific goals of the service (DO use bullet points):
• Administration of LOOK assessment compliant with assessment guidelines.
Additional administration of assessment if warranted
• Report outlining results of the assessment.
2.4e Three (3), or more, specific outcomes of service:
Determined per case.
2.4f Target population of the service:
Tindall, Bartels & Associates conduct evaluations for all ages, all genders, all races, including DD/ID, LGBTQ.
2.4g Languages service is available in (please list proficiency and if interpreter services are available):
Possibility of Spanish interpretation if not available from the referral source.
2.4h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part:
No
Service #5
Name:
2.5a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points):
2.5b Anticipated frequency of service per week (i.e. 4 hours/week):
2.5c Anticipated duration of service (i.e. 3-4 months):
2.5d Three (3), or more, specific goals of the service (DO use bullet points):
2.5e Three (3), or more, specific outcomes of service:
2.5f Target population of the service:
2.5g Languages service is available in (please list proficiency and if interpreter services are available):
2.5h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part
Section 3 — Service Access and Transportation
REV. NOV 2019 5
ATTACHMENT C - PROPOSAL TEMPLATE
3.1 Will you conduct services in your
office?
3.1a
If yes, office
location(s):
Yes
3 locations: 1122 9t1 Street, #203, Greeley, CO 80631; 2625 Redwing Road, #307, Fort
Collins, CO 80526; 8811 E. Hampden Avenue, #202, Denver, CO 80631.
3.2 Will you conduct services out of the
office?
Yes
3.2a If yes, how many miles will you travel from your
office?
3.3 Will you transport clients to and from
services?
3.3a If yes, what is your starting point
address?
Within 30 mile radius
No
3.3b If yes, how many miles will you travel from your starting point address?
SECTION 4 - SERVICE RATES
All rates need to include administrative work (i.e. report writing). Rates cannot be per episode, except for home studies and
monitored sobriety testing. Only hourly, daily, or monthly rates will be accepted for services, with the exception those listed above.
Home study providers need to list their rates in 4.6. Monitored sobriety testing providers needs to list their rates in 4.7.
4.1
Service #1
Name:
Offense Specific Evaluations
4.1a In -Office rate:
4.1 b Out -of -office rate:
4.1c
4.1d
4.1e
FTM, TDM, Prof.
Staffing:
No show:
Mileage rate after
catchment:
$ Amount
$950
$1050
$150
$057
per
per
per
per
per Mile
Unit Type
Evaluation
Evaluation
TDM/FTM/Staffing
Catchment area in
miles:
4.1f If the rate(s) listed above are a monthl acka e, complete the boxes below.
No. of Face-to-face hours: per month
No. of admin/case management per month
hours:
No. of travel hours
TOTAL HOURS:
per month
per month
30
Miles
4.2 Service #2
Name:
DD Offense Specific Evaluations
4.2a In -Office Rate:
4.2b Out -of -Office Rate:
4.2c
4.2d
4.2e
FTM, TDM, Prof.
Staffing:
No show:
Mileage rate after
catchment:
$ Amount
$1600
$1750
$150
$.57
per
per
per
per
per Mile
Unit Type
Evaluation
Evaluation
TDM/FTM/Staffing
Catchment area in
miles:
4.2f If the rate(s) listed above are a monthl acka e, complete the boxes below.
No. of Face-to-face hours: per month
No. of admin/case management per month
hours:
No. of travel hours per month
TOTAL HOURS: per month
30
Miles
REV. NOV 2019
6
ATTACHMENT C - PROPOSAL TEMPLATE
4.3
Service
Name:
#3
Consultation
Services
$ Amount
Unit
Type
4.3a In -Office
Rate:
$150
per
Assessment
4.3b
Out -of -Office Rate:
per
Catchment
miles:
area in
30
Miles
4.3c
FTM,
TDM,
Staffing:
Prof.
per
4.3d
No
show:
per
4.3e
Mileage
rate
catchment:
after
$.57
per
Mile
4.3f
If
the
rate(s)
listed
above
are a monthly
package,
complete
the
boxes
below.
No.
of
Face-to-face
hours:
per
month
No.
of
admin/case
management
hours:
per
month
No.
of
travel
hours
per
month
TOTAL
HOURS:
per
month
4.4
Service
Name:
#4
The
LOOK
Assessment
$
Amount
Unit
Type
4.4a
In
-Office
Rate:
$100
per
Assessment
4.4b
Out
-of
-Office
Rate:
per
Catchment
miles:
area in
30
Miles
4.4c
FTM,
TDM,
Staffing:
Prof.
per
4.4d
No
show:
per
4.4e
Mileage
catchment:
rate
after
$.57
per
Mile
4.4f
If
the
rate(s)
listed
above
are
a monthly
package,
complete
the
boxes
below.
No.
of
Face-to-face
hours:
per month
No.
of admin/case
management
hours:
per month
No.
of travel
hours
per month
TOTAL
HOURS:
per month
4.5
Service
Name:
#5
$ Amount
Unit
Type
4.5a
In -Office
Rate:
per
4.5b
Out
-of -Office
Rate:
per
Catchment
area in
Miles
miles:
4.5c FTM,
TDM,
Staffing:
Prof.
per
4.5d
No
show:
per
4.5e
Mileage
rate
catchment:
after
per
Mile
4.5f
If
the
rate(s)
listed
above
are a monthl
acka
e, complete
the
boxes
below.
No.
of Face-to-face hours:
per month
No.
of
admin/case
management
hours:
per month
No.
of
travel
hours
per month
TOTAL
HOURS:
per month
4.6
Home Study
Providers
—
List
your rates
in the
box
below.
4.7 Monitored
Sobriety
Providers
— List your rates in the
box
below.
REV. NOV 2019
7
ATTACHMENT C - PROPOSAL TEMPLATE
Provider special notes:
Translator can be provided for $120 flat fee for evaluations or $10/per 15 minutes on an as -needed basis.
REV. NOV 2019
8
ATTACHMENT C m PROPOSAL TEMPLATE
Please type your answers in the boxes below.
SECTION 1 — Provider and Program Area Information
Bidder's Legal
Name:
Program
Area:
Tindall, Bartels & Associates, LLC
Mental Health Services
Number of services offered on this Exhibit C (max 5):
Program Areas are listed in column 1 of the table located in Item XI of the You may complete another Exhibit Cif you have more than 5.
Request for Proposal starting on page 13.
3
Service #1
Name:
Zola Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points):
SECTION 2 — Service Name(s) and Information
Cognitive Evaluations
In -person evaluations using cognitive testing if needed.
2.1b Anticipated frequency of service per week (i.e. 4 hours/week):
Tindall, Bartels & Associates have 3 office locations and 3 clinicians, so are able to do all evaluations within a
reasonable amount of time, and some on short -notice. The hours depend on the extent of the evaluation.
2.1c Anticipated duration of service (i.e. 3-4 months):
Dependent on the extent of evaluation. Typically completed within 90 days.
2.1d Three (3), or more, specific goals of the service (DO use bullet points):
Goals of the service determined based on the referral question, the clinician will work with the referral source to
determine the appropriate type of evaluation to answer the referral question.
• Assess cognitive functioning areas based on referral question, potentially including IQ achievement, and adaptive
functioning
• Recommendations offered based on answers to referral questions.
• Testing used may include: WAIS-IV, WISC-V, WRAT-5, WIAT-Ill, Vineland -3, SRS -2
2.1e Three (3), or more, specific outcomes of service:
• Answer identified referral questions
• Appropriately assess client's current level of cognitive functioning
• Provide clinical insight related to client's level of cognitive functioning
• Timely evaluation report
2.1f Target population of the service, including age and gender:
Tindall, Bartels & Associates conduct evaluations for all ages, all genders, all races, including DD/ID, LCBTQ.
2.1g Languages service is available in (please list proficiency and if interpreter services are available):
Possibility of Spanish interpretation if not available from the referral source.
2.Ih Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part:
No
Service #2
Name:
2.2a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points):
Trauma Evaluations
In -person evaluations using psychological testing if needed.
2.2b Anticipated frequency of service per week (i.e. 4 hours/week):
Determined per case.
2.2c Anticipated duration of service (i.e. 3-4 months):
Dependent on Client. Typically completed within 90 days.
2.2d Three (3), or more, specific goals of the service (DO use bullet points):
• Goals of the service determined based on the referral question, the clinician will work with the referral source to
determine the appropriate type of evaluation to answer the referral question.
• Assess client's level of trauma and impact of trauma as it relates to the referral question.
• Recommendations offered based on answers to referral questions.
REV. NOV 2019 1
ATTACHMENT C - PROPOSAL TEMPLATE
• Testing used may include: MMPI-2, MMPI-A, MMPI-2-RF, MMPI-A-RF, MACI, MCMI-IV, TSCC, TSI-2, Rorschach, PAI,
PAI-A
2.2e Three (3), or more, specific outcomes of service:
® Answer identified referral questions
• Appropriately assess client's current level of trauma and trauma symptomology
• Provide clinical insight related to client's trauma symptomology
• Timely evaluation report
2.2f Target population of the service:
Tindall, Bartels & Associates conduct evaluations for all ages, all genders, all races, including DD/ID, LGBTQ.
2.2g Languages service is available in (please list proficiency and if interpreter services are available):
Possibility of Spanish interpretation if not available from the referral source.
2.2h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part:
No
Service #3
Name:
2.3a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points):
Psychological evaluations (including full psychological evaluations)
In -person evaluations using psychological testing if needed.
2.3b Anticipated frequency of service per week (i.e. 4 hours/week):
Determined per case. Assessments are typically 3-5 hours of direct client contact with a psychologist.
2.3c Anticipated duration of service (i.e. 3-4 months):
2.3d
2.3e
Determined per case. Typically completed within 90 days.
Three (3), or more, specific goals of the service (DO use bullet points):
• Goals of the service to answer questions about psychological variables (emotional state, personality, pathology,
behavior and cognitive/intellectual ability using formal testing, collateral information and clinical judgement.
® The evaluator provides a comprehensive conceptualization (including mental health diagnosis) of the individual
that answers the referral question and provides greater insight and clarity into his/her psychological functioning.
• The evaluator provides recommendations that will likely be most effective and efficient in meeting the parent's
and/or child's needs.
• The evaluation can be useful in assessing the strengths and weaknesses of an individual and how these can impact
the individual's capacity to parent a child.
Recommendations offered based on answers to referral question.
Three (3), or more, specific outcomes of service:
Provide Timely report addressing the concerns in the referral
Provide clinical insights and testing into the rental health of the referred client
Provide appropriate diagnosis and recommendations
2.3f Target population of the service:
Tindall, Bartels & Associates conduct evaluations for all ages, all genders, all races, including DD/ID, LGBTQ.
2.3g Languages service is available in (please list proficiency and if interpreter services are available):
Tindall, Bartels & Associates conduct evaluations for all ages, all genders, all races, including DD/ID, LGBTQ,
2.3h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part:
No
Service #4
Name:
2.4a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points):
2.4b Anticipated frequency of service per week (i.e. 4 hours/week):
2.4c Anticipated duration of service (i.e. 3-4 months):
2.4d Three (3), or more, specific goals of the service (DO use bullet points):
2.4e Three (3), or more, specific outcomes of service:
REV. NOV 2019 2
ATTACHMENT C - PROPOSAL TEMPLATE
2.4f
Target
population
of the service:
2.4g
Languages
service is available
in (please
list
proficiency and if
interpreter
services are available):
2.4h
Medicaid
eligibility
— list
whether
the
service is eligible
for Medicaid
in whole
or in
part:
Service
Name:
#5
2.5a
Modalities,
curriculum, tools
used in delivery
of
service (DO
NOT list company
history;
DO use
bullet
points):
2.5b
Anticipated
frequency
of service
per week
(i.e. 4
hours/week):
2.5c
Anticipated
duration
of
service
(i.e. 3-4 months):
2.5d
Three (3), or more, specific
goals
of
the service (DO
use
bullet
points):
2.5e
Three (3), or more, specific
outcomes
of
service:
2.5f
Target
population
of the
service:
2.5g
Languages service is available
in
(please
list
proficiency and
if
interpreter
services are available):
2.5h
Medicaid
eligibility
— list
whether
the service is eligible
for
Medicaid
in whole
or in
part
Section
3 — Service Access and Transportation
3.1
Will
office?
you conduct
services in your
Yes
3.1a
If
location(s):
yes,
office
3 locations:
Collins,
1122
CO
80526;
9th Street,
8811
E.
#203,
Hampden
Greeley,
CO 80631;
Avenue, #202,
2625
Denver,
Redwing
CO
80631.
Road,
#307, Fort
3.2 Will
office?
you
conduct
services out
of
the
Yes
3.2a If
yes,
how many
miles
will
you travel
from your
Within
30 mile radius
office?
3.3 Will you transport clients
services?
to and
from
No
3.3a If
address?
yes,
what
is your starting
point
3.3b
If yes, how many miles will
you travel
from your starting
point address?
SECTION 4 - SERVICE RATES
All rates need to include administrative work (i.e. report writing). Rates cannot be per episode, except for home studies and
monitored sobriety testing. Only hourly, daily, or monthly rates will be accepted for services, with the exception those listed above.
Home study providers need to list their rates in 4.6. Monitored sobriety testing providers needs to list their rates in 4.7.
4.1
Service #1
Name:
Cognitive Evaluations
4.1a In -Office rate:
4.1b Out -of -office rate:
$ Amount
$1600
$1750
per
per
Unit Type
Evaluation
Evaluation
Catchment area in
miles:
30
Miles
REV. NOV 2019
3
ATTACHMENT C - PROPOSAL TEMPLATE
4.1c
4.1d
4.1e
FTM, TDM, Prof.
Staffing:
No show:
Mileage rate after
catchment:
$150
$.57
per
per
per Mile
TDM/FTM/STaffing
4.1f If the rate(s) listed above are a monthl acka e, complete the boxes below.
No. of Face-to-face hours: per month
No. of admin/case management per month
hours:
No. of travel hours
TOTAL HOURS:
per month
per month
4.2 Service #2
Name:
Trauma Evaluations
4.2a In -Office Rate:
4.2b Out -of -Office Rate:
4.2c
4.2d
4.2e
FTM, TDM, Prof.
Staffing:
No show:
Mileage rate after
catchment:
$ Amount
$1600
$1750
$150
$.57
per
per
per
per
per Mile
4.2f If the rate(s) listed above are a monthl
No. of Face-to-face hours:
No. of admin/case management
hours:
No. of travel hours
TOTAL HOURS:
YP
acka
g
Unit
Type
Evaluation
Evaluation
TDM/FTM/Staffing
Catchment area in
miles:
e, complete the boxes below.
per month
per month
per month
per month
30
Miles
4.3 Service #3
Name:
Psychological evaluations (including full psychological evaluations)
4.3a In -Office Rate:
4.3b Out -of -Office Rate:
4.3c
4.3d
4.3e
FTM, TDM, Prof.
Staffing:
No show:
Mileage rate after
catchment:
$ Amount
$1600
$1750
$150
$.57
per
per
per
per
per
Unit
Type
Evaluation
Evaluation
TDM/FTM/Staffing
Mile
Catchment area in
miles:
4.3f If the rate(s) listed above are a monthl acka e, complete the boxes below.
No. of Face-to-face hours: per month
No. of admin/case management per month
hours:
No. of travel hours
TOTAL HOURS:
per month
per month
30
Miles
4.4 Service #4
Name:
4.4a In -Office Rate:
4.4b Out -of -Office Rate:
4.4c
4.4d
FTM, TDM, Prof.
Staffing:
No show:
$ Amount
per
per
per
per
Unit Type
Catchment area in
miles:
Miles
REV. NOV 2019
4
ATTACHMENT C - PROPOSAL TEMPLATE
4.4e Mileage rate after
catchment:
per Mile
4.4f If the rate(s) listed above are a monthl acka e, complete the boxes below.
No. of Face-to-face hours: per month
No. of admin/case management per month
hours:
No. of travel hours
TOTAL HOURS:
per month
per month
4.5 Service #5
Name:
4.5a
4.5b
4.5c
4.5d
4.5e
In -Office Rate:
Out -of -Office Rate:
FTM, TOM, Prof.
Staffing:
No show:
Mileage rate after
catchment:
$ Amount
per
per
per
per
Unit Type
per Mile
Catchment area in
miles:
4.5f If the rate(s) listed above are a monthl acka e, complete the boxes below.
No. of Face-to-face hours: per month
No. of admin/case management per month
hours:
No. of travel hours
TOTAL HOURS:
per month
per month
Miles
4.6 Home Study Providers — List your rates in the box below.
4.7 Monitored Sobriety Providers — List your rates in the box below.
Provider special notes:
Translator can be provided for $120 flat fee for evaluations or $10/per 15 minutes on an as -needed basis.
REV. NOV 2019
5
STAFF DATA SHEET (Bidder must list all applicable staff who will manage and/or administer EXhieaaAfed service. One Staff Data Sheet per proposed ser
PROPOSED SERVICE OR SERVICE
TYPE:
(Mental
Health
Services/Evaluations
BIDDER LEGAL ENTITY NAME:
;:Tindall, Bartels & Associates, LLC
.._.. __
E STAFF MEMBER OR CONTRACTOR INFORMATION
APPLE r� ABL,
__,.-. •� •
No
Last
Narn
First Name
Work#
Work
Email
Education
Degree Focus
Licensure/ Credentials
DORA #
Las
1
1
Tindall
Brenna
97G-231-9611
dr.tindall@tindall-bartels.com
�tindall-bartels.com
Psy.D.
Psychology
Licensed Psychologist
PSY.0003709
2
Bartels
Jessica
97G-231-9611
dr.bartels@tindall-bartels.com
Psy.D.
Psychology
Licensed Psychologist
PSY.0003746
4
Tippet
Jennifer
720-266-7429
dr.tippett
tindall-bartels.com
Psychology
Licensed Psychologist
4648
S
6
7
8
9
10
11
12
13
14
15
17
18
19
20
21
22
23
24
25
26
t
27
28
Bid No.: B1900025
ACORO
CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/DDIYYYY)
01/13/2020
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
Trust Risk Management Services, Inc. doing business in CO as
Potomac Risk Management Services, inc.
1791 Paysphere Circle
Chicago, IL 60674
INSURED
Dr. Jessi Bartels
Tindall, Bartels, & Associates
1122 9Th St Ste 203
Greeley, CO 80631 3277
COVERAGES
CERTIFICATE NUMBER:
CONTACT
NAME: Trust Risk Management Services, Inc.
PHONE
(NC, No, Ext): 877.637.9700
EMAIL
ADDRESS: info@trustrms.com
FAX
(A/C, No): 877.251.5111
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURER A: ACE American Insurance Company
INSURER B:
22667
INSURER C:
INSURER D:
INSURER E:
INSURER F:
REVISION NUMBER:
INDICATED.
THIS IS
CERTIFICATE
EXCLUSIONS
TO CERTIFY
NOTWITHSTANDING
MAY BE
AND CONDITIONS
THAT
ISSUED
THE POLICIES OF
ANY REQUIREMENT,
OR MAY PERTAIN,
OF SUCH
INSURANCE
POLICIES.
TERM
THE INSURANCE
LIMITS
LISTED
OR
SHOWN
BELOW
CONDITION
AFFORDED
MAY
HAVE
OF
HAVE
BEEN
ANY
BY THE
BEEN
ISSUED TO
CONTRACT
POLICIES
REDUCED
BY
THE
OR
INSURED
OTHER
DESCRIBED
PAID
CLAIMS.
NAMED
DOCUMENT
HEREIN
ABOVE FOR
WITH RESPECT
IS SUBJECT
THE
TO
POLICY PERIOD
TO WHICH THIS
ALL THE TERMS,
INSR
LTR
TYPE OF INSURANCE
ADDL
INSR
SUBR
ViND
POLICY NUMBER
POLICY EFF
(MMIDD/YYYY)
POLICY EXP
(MM/DDIYYYY)
LIMITS
COMMERCIAL GENERAL LIABILITY
Y
D42201601
_
09/06/2019
•
f
09/06/2020
EACH OCCURRENCE
$1,000,000
$1,000,000
CLAIMS MADE
OCCUR
DAMAGE TO RENTED
PREMISES (Ea occurrence)
MED EXP (Any one person)
$10,000
PERSONAL & ADV INJURY
$1,000,000
A
GENERAL AGGREGATE
$2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS-COMP/OP AGG
$2,000,000
X
POLICY
PRO-
JECT
LOC
OTHER:
AUTOMOBILE LIABILITY
-W
,,,_
a-
,
COMBINED SINGLE LIMIT
$
(Ea acciden₹)
BODILY INJURY (Per Person)
$
ANY AUTO
BODILY INJURY
(Per accident)
$
ALL OWNED
AUTOS
SCHEDULED
AUTOS
PROPERTY DAMAGE
(Per accident)
$
HIRED AUTOS
NON -OWNED
AUTOS
$
UMBRELLA UAB
OCCUR
i
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LIAB
CLAIMS -MADE
$
DED
RETENTIONS
WORKERS COMPENSATION
AND EMPLOYERS LIABILITY Y / N
N / A
_
PER
STATUTE
OTI
-ER
E. L. EACH ACCIDENT
S
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L. DISEASE -EA EMPLOYEE
$
OFFICER/MEMBER EXCLUDED?
(Mandatory in NI -I)
If yes, describe under
EL DISEASE - POLICY LIMIT
$
DESCRIPTION OF OPERATIONS below
DESCRIPTION
Board
OF OPERATIONS I LOCATIONS I
Of county Commissioners of Weld
VEHICLES (ACORD
County and
101, Additional Remarks Schedule, may be attached
its Officers/Employee are included as additional
if more
space is required):
insurded.
CERTIFICATE HOLDER
CANCELLATION
Additional
Weld
1150
Greeley,
Interest
County
0 Street
CO, 80631
SHOULD ANY
BEFORE THE
IN ACCORDANCE
OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED
WITH THE POLICY PROVISIONS.
AUTHORIZED
REPRESENTATIVE
ACORD 25 (2016/03)
@1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
EXHIBIT C
SCOPE OF SERVICES
a. Contractor will provide Mental Health Services and Sexual Abuse Treatment, as referred by the
Department.
Mental Health Services:
b. Cognitive Evaluations: Contractor will provide in -person evaluations using cognitive testing if needed.
Testing may include: WAIS-IV, WISC-V, WRAT-5, WIAT-III, Vineland -3, SRS -2.
c. Anticipated Duration of Services: Dependent on the extent of evaluation. Typically completed within
three (3) months.
d. Goals of Services:
a. The clinician will work with the referral source to determine the appropriate type of evaluation
needed to answer the referral question.
b. Assess cognitive functioning areas based on referral question potentially including IQ,
achievement, and adaptive functioning.
c. Based on answers to the referral questions, the clinician will provide recommendations for
treatment.
e. Outcomes of Services:
a. Answer identified referral questions.
b. Appropriately assess client's current level of cognitive functioning.
c. Provide clinical insight related to client's level of cognitive functioning.
d. Provide a timely evaluation report.
f. Trauma Evaluations: Contractor will provide in -person evaluations using psychological testing if needed.
Testing may include: MMPI-2, MMPI-A, MMPI-2-RF, MMPI-A-RF, MACI, MCMI-IV, TSCC, TSI-2, Rorschach,
PAI, PAI-A.
g. Anticipated Frequency and Duration of Services: Determined per case. Typically completed within three
(3) months.
h. Goals of Services:
a. The clinician will work with the referral source to determine the appropriate type of evaluation
needed to answer the referral question.
b. Assess client's level of trauma and impact of trauma as it relates to the referral question.
c. Based on answers to the referral questions, the clinician will provide recommendations for
treatment.
i. Outcomes of Services:
a. Answer identified referral questions.
b. Appropriately assess client's current level of trauma and trauma symptomology.
c. Provide clinical insight related to client's trauma symptomology.
d. Provide a timely evaluation report.
j. Psychological Evaluations (including full psychological evaluations): Contractor will provide in -person
evaluations using psychological testing if needed.
k. Anticipated Frequency and Duration of Services: Three (3) to five (5) hours of direct contact with the
psychologist. Treatment is typically completed within three (3) months.
I. Goals of Services:
a. Provide answers to questions regarding psychological variables: emotional state, personality,
pathology, behavior and cognitive/intellectual ability using formal testing, collateral information
and clinical judgement.
b. Provide a comprehensive conceptualization (including mental health diagnosis), of the individual
that answers the referral question and provides greater insight and clarity into his/her
psychological functioning.
c. Provide recommendations that will meet the parent's and/or child's needs.
d. Assess the strengths and weaknesses of an individual and provide feedback on how the results
can impact the individual's capacity to parent a child.
e. Provide recommendations based on answers to the referral question.
m. Outcomes of Services:
a. Provide testing and evaluate the mental health of the referred client.
b. Provide appropriate diagnosis and recommendations.
c. Provide a timely evaluation report.
n. Target Population:
a. Contractor does not discriminate based on race, gender, religion, national origin, physical or
mental disability, age, sexual orientation or gender identity.
o. Service Access and Transportation: Within a thirty (30) mile radius of practitioner's offices located at:
a. 1122 9th Street, #203, Greeley, CO 80631
b. 2625 Redwing Road, #307, Fort Collins, CO 80526
c. 8811 East Hampden Avenue #202, Denver, CO 80631
d. Contractor will not transport clients to and from service
p. Language:
a. English
b. Contractor will attempt to hire a Spanish interpreter, when needed.
Sexual Abuse Treatment:
q. Offense Specific Evaluations — Adult SOMB/DVOMB Standards:
a. The purpose of a mental health sex offense -specific evaluation (hereafter evaluation) is to assess
a client's need for treatment, determine what type of treatment is needed, and identify the risk
level and any additional needs the client may have.
b. Treatment considerations should be based on the conclusions and recommendations of the
evaluation. While the evaluation provides valuable information and recommendations, it should
be viewed as fluid. As new information emerges, or risk level changes within the course of
treatment, a client's treatment should be tailored to address those changes.
c. Because of the importance of the initial information to subsequent sentencing, supervision,
treatment, and behavioral monitoring, each client shall receive a thorough assessment and
evaluation that examines the interaction between the client's mental health, social/systemic
functioning, family and environmental functioning, and offending behaviors.
d. Sex offense -specific evaluations are not intended to replace more comprehensive psychological
or neuropsychological evaluations. Evaluators have an ethical responsibility to conduct
evaluations in a comprehensive and factual manner, regardless of the client's status within the
criminal justice system.
e. Evaluations recommending sex offense -specific treatment should suggest the use of research
informed treatment, management, and monitoring interventions that are appropriate for the risk
level, needs, and responsivity of each individual client and that minimize that
client's likelihood to sexually reoffend.
f. Consequently, evaluators will prioritize the physical and psychological safety of victims and
potential victims in making recommendations that are appropriate to the assessed risk and
needs of each client.
g. Evaluation(s) shall be conducted to identify the following factors: risk of re -offense and/or
further abuse, offender criminogenic needs, offender responsivity to treatment, and other
treatment issues as identified in Section 4.08 "Required Minimum Sources of Information." These
factors shall assist in determining recommendations regarding offender treatment.
r. Goals of Services:
a. Initial offender Treatment Plan with the understanding that assessment is an ongoing process,
which may necessitate changes to the plan.
b. Evaluation(s) shall direct initial placement of the offender into the appropriate level and intensity
of treatment as identified in Standard 5.06.
c. Identification of individual criminogenic factors/needs, strategies for managing criminogenic
factors/needs and potential destabilizing factors, and identification of offender strengths.
s. Offense Specific Evaluations —Juvenile SOMB Standards:
a. Evaluations are conducted to identify levels of risk and specific risk factors that require attention
in treatment and supervision, and to assist the court in determining the most appropriate
sentence for juveniles. Due to the importance of the information to subsequent sentencing,
supervision, treatment and behavioral monitoring, each juvenile who has committed a sexual
offense shall receive a thorough assessment and evaluation that examines the interaction of the
juvenile's mental health, social/systemic functioning, family and environmental functioning, and
offending behaviors.
b. A thorough review of relevant prior treatment and supervision information can aid in the
planning of treatment needs for the client and ensure continuity of care. It is imperative that the
evaluator make every reasonable effort to identify and obtain past records to determine what
treatment may have been completed, what components of treatment need additional focus, and
what components of treatment have not yet been completed.
t. Goals of Services:
a. Provide written clinical assessment of a juvenile's strengths, risks and needs; identify and
document treatment and developmental/cognitive needs; identify individual differences,
potential barriers to treatment, and static and dynamic risk factors; make recommendations for
the management and supervision of the juvenile.
b. Recommendations for intervention shall be included in the summary and the evaluation shall be
provided in written form to the referring agent.
u. Outcomes of Services:
a. Answer identified referral questions.
b. Appropriately assess client's strengths, risks, and needs.
c. Make recommendations for the management and supervision of the juvenile.
d. Provide a timely evaluation report.
v. Anticipated Frequency and Duration of Services: Determined per case. Typically completed within three
(3) months.
w. ID/DD Offense Specific Evaluations — Adult Standards:
a. The purpose of a mental health sex offense -specific evaluation (hereafter evaluation) is to assess
a client's need for treatment, determine what type of treatment is needed, and identify the risk
level and any additional needs the client may have.
b. Treatment considerations should be based on the conclusions and recommendations of the
evaluation. While the evaluation provides valuable information and recommendations, it should
be viewed as fluid. As new information emerges, or risk level changes within the course of
treatment, a client's treatment should be tailored to address those changes.
c. Evaluations recommending sex offense -specific treatment should suggest the use of research
informed treatment, management, and monitoring interventions that are appropriate for the risk
level, needs, and responsivity of each individual client and that minimize that
client's likelihood to sexually reoffend.
d. Conducted per Standards /Guidelines specific to ID/DD Clients.
x. Goals of Services:
a. Each client shall receive a thorough assessment and evaluation that examines the interaction
between the client's mental health, social/systemic functioning, family and environmental
functioning, and offending behaviors.
V.
ID/DD Offense Specific Evaluations — Juvenile Standards:
a. Evaluations are conducted to identify levels of risk and specific risk factors that require attention
in treatment and supervision, and to assist the court in determining the most appropriate
sentence for juveniles. Due to the importance of the information to subsequent sentencing,
supervision, treatment and behavioral monitoring, each juvenile who has committed a sexual
offense shall receive a thorough assessment and evaluation that examines the interaction of the
juvenile's mental health, social/systemic functioning, family and environmental functioning, and
offending behaviors.
b. A thorough review of relevant prior treatment and supervision information can aid in the
planning of treatment needs for the client and ensure continuity of care. To this end, it is
imperative that the Evaluator make every reasonable effort to identify and obtain past records to
determine what treatment may have been completed, what components of treatment need
additional focus, and what components of treatment have not yet been completed.
c. Sex offense specific evaluations are not intended to supplant more comprehensive psychological
or neuropsychological evaluations. Evaluators have an ethical responsibility to conduct
evaluations in a comprehensive and factual manner regardless of the juvenile's status within the
criminal justice system.
d. The evaluation of juveniles who have committed sexual offenses has the following purposes: To
assess overall risk to the community; provide protection for victims and potential victims;
provide written clinical assessment of a juvenile's strengths, risks and needs; identify and
document treatment and developmental/cognitive needs; identify individual differences,
potential barriers to treatment, and static and dynamic risk factors; make recommendations for
the management and supervision of the juvenile; provide information which can help identify the
type and intensity of community based treatment, or the need for a more restrictive setting.
z. Goals of Services:
a. The evaluation of juveniles who have committed sexual offenses shall be comprehensive.
b. Recommendations for intervention shall be included in the summary and the evaluation shall be
provided in written form to the referring agent.
aa. Outcomes of Services:
a. Answer identified referral questions.
b. Appropriately assess client's strengths, risks and needs.
c. Make recommendations for the management and supervision of the juvenile.
d. Provide a timely evaluation report.
bb. Anticipated Frequency and Duration of Services: Determined per case. Typically completed within three
(3) months.
cc. Consultation Services:
dd. Goals of Services:
a. Review case records and provide informal risk assessments.
b. Create a treatment or supervision plan to help determine a referral source for the most cost-
effective, evidence based, collaborative, trauma -informed approach to treatment.
c. Reviewing case records and provide informal risk assessments.
d. Provide expert testimony and preparation of summary reports and recommendations.
ee. Outcomes of Services:
a. Answer identified referral questions.
ff. LOOK Assessment:
gg. Goals of Services:
a. Administration of LOOK assessment compliant with assessment guidelines.
b. Provide a timely evaluation report.
hh. Outcome of Services:
a. Determined per case.
ii. Anticipated Frequency and Duration of Services: Determined per case.
jj•
jj
Target Population:
a. Contractor does not discriminate based on race, gender, religion, national origin, physical or
mental disability, age, sexual orientation or gender identity.
Service Access and Transportation: Within a thirty (30) mile radius of practitioner's offices located at:
b. 1122 9th Street, #203, Greeley, CO 80631
c. 2625 Redwing Road, #307, Fort Collins, CO 80526
d. 8811 East Hampden Avenue #202, Denver, CO 80631
e. Contractor will not transport clients to and from services.
kk. Language:
a. English
b. Contractor will attempt to hire a Spanish interpreter, when needed.
II. Contractor will respond to the Quality Assurance Team Supervisor (hainleid@weldgov.com, 970-400-
6210) within three (3) business days regarding the ability to accept the received referral.
mm. 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
(hainleid@weldgov.com, 970-400-6210).
nn. 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 (hainleid@weldgov.com, 970-400-6210).
oo. 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 (hainleid@weldgov.com) immediately via email,
to discuss service continuation.
pp. 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.
qq. 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.
rr. 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.
ss. 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.
tt. Contractor agrees to attend meetings when available and as requested by the Department. Such meetings
include Court Facilitations, Court Staffing's, Family Team Meetings and/or Team Decision Making
meetings. Contractor may participate by phone, if approved by the Department.
uu. Contractor will notify the Quality Assurance Team Supervisor (hainleid@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 D
RATE SCHEDULE
1. Funding and Method of Payment
The Department agrees to reimburse the Contractor in consideration of the work and services performed
under this Agreement at the rate 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 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
Cognitive Evaluations
$1600.00/Evaluation (In -Office)
$1750.00/Evaluation (Out -of -Office)
$150.00/Hour (FTM, TDM, Prof. Staffing)
$120.00/Flat Fee (Translator)
$10.00/15 minutes (Translator)
$ .57/Mile (Mileage) — For distance exceeding thirty (30) miles from practitioner's main office or satellite
office locations.
Trauma Evaluations
$1600.00/Evaluation (In -Office)
$1750.00/Evaluation (Out -of -Office)
$150.00/Hour (FTM, TDM, Prof. Staffing)
$120.00/Flat Fee (Translator)
$10.00/15 minutes (Translator)
$ .57/Mile (Mileage) — For distance exceeding thirty (30) miles from practitioner's main office or satellite
office locations.
Psychological Evaluations
$1600.00/Evaluation (In -Office)
$1750.00/Evaluation (Out -of -Office)
$150.00/Hour (FTM, TDM, Prof. Staffing)
$120.00/Flat Fee (Translator)
$10.00/15 minutes (Translator)
$ .57/Mile (Mileage) — For distance exceeding thirty (30) miles from practitioner's main office or satellite
office locations.
Offense Specific Evaluations
$950.00/Evaluation (In -Office)
$1050.00/Evaluation (Out -of -Office)
$150.00/Hour (FTM, TDM, Prof. Staffing)
$120.00/Flat Fee (Translator)
$10.00/15 minutes (Translator)
$ .57/Mile (Mileage) — For distance exceeding thirty (30) miles from practitioner's main office or satellite
office locations.
ID/DD Offense Specific Evaluations
$1600.00/Evaluation (In -Office)
$1750.00/Evaluation (Out -of -Office)
$150.00/Hour (FTM, TDM, Prof. Staffing)
$120.00/Flat Fee (Translator)
$10.00/15 minutes (Translator)
$ .57/Mile (Mileage) — For distance exceeding thirty (30) miles from practitioner's main office or satellite
office locations.
Consultation
$150.00/Assessment (In -Office or Out -of -Office)
$120.00/Flat Fee (Translator)
$10.00/15 minutes (Translator)
$ .57/Mile (Mileage) — For distance exceeding thirty (30) miles from practitioner's main office or satellite
office locations.
LOOK Assessment
$100.00/Assessment (In -Office or Out -of -Office)
$120.00/Flat Fee (Translator)
$10.00/15 minutes (Translator)
$ .57/Mile (Mileage) — For distance exceeding thirty (30) miles from practitioner's main office or satellite
office locations.
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 7th 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
New Contract Request
Entity Name* Entity ID*
TINDALL. BARTELS. & ASSOCIATES, W0042212
LLC
Contract Name*
TINDALL. BARTELS. & ASSOCIATES, LLC
Contract Status
CTB REVIEW
❑ New Entity?
Contract ID
3542
Contract Lead*
CULLINTA
Contract Lead Email
cullinta@co co weld co.us
Parent Contract ID
Requires Board Approval
YES
Department Project #
Contract Description*
CONSENT. BID NO. 2000037. BOCC APPROVAL 04/15/20.
NEW AGREEMENT FOR SERVICES. TERM. 06/01/20 THROUGH 05/31/21. FUNDING: CORE/OTHER
Contract Description 2
Contract Type*
AGREEMENT
Amount *
SO 00
Renewable*
YES
Automatic Renewal
Grant
IGA
Department
HUMAN SERVICES
Department Email
CM-
HumanServices@weldgov corn
Department Head Email
CM-HumanSerrices-
DeptHead@weldgov.com
County Attorney
GENERAL COUNTY
ATTORNEY EMAIL
County Attorney Email
C M-
COUNTYATTORNEY@WELD
GOV. COM
Requested BOCC Agenda
Date*
0412212020
Due Date
0412/2020
Will a work session with BOCC be required?*
NO
Does Contract require Purchasing Dept. to be included?
tf 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*
0401/2021
Termination Notice Period Committed Delivery Date
Renewal Date*
06/01)2021
Expiration Date
Contact Information
Contact Info
Contact Name
Purchasing
Purchasing Approver
Approval Process
Department Head
JAMIE ULRICH
OH Approved Date
04/30/2020
Final Approval
BOCC Approved
BOCC Signed Date
BOCC Agenda Date
Originator
SNYDERKL
Contact Type
Contact Email
Finance Approver
BARB CONNOLLY
Contact Phone 1 Contact Phone 2
Purchasing Approved Date
Finance Approved Date
050412020
Tyler Ref*
CONSENT
Legal Counsel
GABE KALOUSEK
Legal Counsel Approved Date
05!04/2020
Submit
Hello