HomeMy WebLinkAbout20201254.tiffC 174 -TP#333Y
CHILD PROTECTION AGREEMENT FOR SERVICES
BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES
AND LAURICE FRIHAUF
This Agreement, made and entered into th�day of 020, by and between the Board of
Weld County Commissioners, on behalf of the Weld County Depart ent of Human Services, hereinafter referred
to as the "Department' and Laurice Frihauf, 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, Exhibits 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.
W1TNESSETH
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 Home Studies.
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.
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.
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
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unscheduled face-to-face services with the exception of home studies and monitored sobriety
testing. Contractor agrees that original complete Client Verification Forms 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. psychological
evaluation, 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.
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
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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
- 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
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- 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.
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
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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-
76.5-101, et seq., and (c) shall produce one of the forms of identification required by C.R.S. § 24-76.5-
103 prior to the effective date of the contract.
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
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
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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.
ii.Commercial General Liability Insurance written on ISO occurrence form CG 00 0110/93
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;
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- $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
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.
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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:
Heather Walker, Child Welfare Division Head
17. Notice
For Contractor:
Laurice Frihauf
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:
Laurice Frihauf
3191 East 133rd Avenue
Thornton, CO 80241
(720) 333-7173
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.
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
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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
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.
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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
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
11
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
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
12
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,
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
13
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:
„W.,drita,v
BOARD OF COUNTY COMMISSIONERS
Weld Co Clerk to the Board ���, WELD COUNTY, COLORADO
By:
Deputy Clerk to t
14
Mike Freeman, Chair
CONTRACTOR:
Laurice Frihauf
3191 East 133rd Avenue
Thornton, CO 80241
(720) 333-7173
By:
Laurire Frihauf IAnr q 7070)
Laurice Frihauf
Date: Apr 9, 2020
APR 2 9 2020
oZoov - /0254'
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.
EXHIBIT B
CONTRACTOR'S RESPONSE TO REQUEST FOR PROPOSAL
Laurice Frihauf
3191 e 133'd Ave
Thornton, CO 80241
01/24/2020
Dear Sir and/or Madam,
I have Certification in SAFE Home Study writing. SAFE Interviewer, and SAFE Supervisor. I also have a
bachelor's degree and about ten years of experience writing investigations, and other controlled
documents that require compliance with government regulations.
I was a Foster Mother during two period of times, adopting two children, ages at the time of placement
9 years old, and 7 years old respectively, now 17 and 11 years old. I have developed a network of
resources in this position. With the knowledge I have learned from fostering, I believe this will help me
write home studies with a better insight.
I have knowledge of and willing to write home studies for Kinship Care, Foster Care, Kinship Foster Care,
Parent Care, Foster -Adoption, and Adoption.
While I worked in Quality and Regulatory in Pharmaceuticals, I not only needed to be organized, I
developed complete Quality Programs, including document control systems. I can respond quickly to
needs and successfully work with clients and WCDHS in scheduling work. In my past career, deadlines
were tight and pressure to meet deadlines was high. I was always able to fulfill this part of the job and
will continue to be able to in the position of Contracted SAFE Home Study writer.
I have the General Liability Insurance, as well as personal auto insurance with an Umbrella policy for
added protection. I will be working out of my home, as listed above.
Thank you for taking the time to consider me for this Contract position.
Laurice Frihauf
1),
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
Agency Name: Laurice Frihauf
Trails Provider ID (If known): NA
Primary Contact Full Name: Laurice Frihauf Title: SAFE Home Study writer, interviewer, and supervisor
Primary Phone Number (10 -digit):
1-(720)-333-7173 Ext.:
Primary Contact Email: lauricefri@gmail.com
Fax Number (10 -digit): NA
Web Address: NA
Agency Location Address (Street, city, state, zip): 3191 e 133rd ave Thornton CO 80241
Agency Mailing Address (Street, city, state, zip): 3191 e 133rd ave Thornton CO 80241
Agency Type (pick one): X Private Private Non -Profit Private for Profit
DHS service referrals should be sent to whom in your organization:
Referral Contact Name: Laurice Frihauf Title: SAFE Home Study writer, interviewer, and supervisor
Referral Phone Number (10 -digit): 1- (720)-333-7173 Ext.:
Email:
lauricefri@gmail.com
Billing Contact
Billing Contact Laurice Frihauf
Billing Phone Number (10 -digit): 1-(720)-333-7173_ Ext.:
Title: SAFE home study writer, interviewer,
supervisor
Email: Iauricefri@Rmail.com
I
(
CERTIFICATION
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 I
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.
I
Authorized Rep. Email: lauricefri@gmail.com
Phone: 1-(7201-333-7173 Ext.: NA
Authorized Rep. Address: 3191 e 133rd Ave Thornton CO 80241
Signature of Authorized Rep. eClAJ.).t0 LV W ' 4-14(
Date: 01-24-2020
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:
Laurice Frihauf
SAFE Home Studies
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 Request You may complete another Exhibit C if you have more than 5.
for Proposal starting on page 13.
3
Sery
2.1a
2.1b
2.1c
2.1d
2.1e
2.1f
2.1g
2.1h
Sery
2.2a
2.2b
2.2c
2.2d
2.2e
2.2f
2.2g
2.2h
ice
Modalities,
#1
Name:
curriculum,
SECTION
2
-
Service
Name(s)
and
Information
Full
Home Study
tools
used in delivery
of
service (DO
NOT
list
company
history;
DO use
bullet
points):
SAFE
Home
Study,
SAFE
Interviewer,
SAFE
Supervisor
certification
Anticipated frequency
of
service
per week
(i.e. 4
hours/week):
20/week
Anticipated
duration
of
service (i.e.
3-4 months):
1-3 months
Three
(3), or more, specific
goals
of
the
service (DO
use
bullet
points):
1.
2.
3.
Accurate
In-depth
Insight
full
home
home
studies
studies
home studies
Three
(3), or more, specific
outcomes of
service:
1.
2.
3.
Foster/Kinship
That
foster/kinship
foster/kinship
families
families
families
feel
that
feel
feel
they
the
their
were
results
time
heard
were
was valued
clearly
accurate
and completely
That
Target
population
of
the
service, including
age and
gender:
1.
2.
From 18-90
Open to all
years old,
genders,
depending
sexual
on capability
orientations,
religious
to provide
beliefs/non-religious
for
the
children
that
beliefs,
may
and
be
races.
placed
in
home.
Languages service is available
in
(please
list
proficiency and
if
interpreter
services are available):
English
only
Medicaid
eligibility
— list
whether
the
service is eligible
for
Medicaid
in whole
or in part:
NA
ice
Modalities,
#2
Name:
curriculum,
Home
Study
updates
tools
used in delivery
of
service (DO
NOT
list
company
history;
DO use
bullet
points):
SAFE Home Study,
SAFE Interviewer,
SAFE Supervisor certification
Anticipated
frequency of service
per week
(i.e. 4
hours/week):
10
hours/ week
Anticipated
duration
of
service (i.e. 3-4
months):
1-2 months
Three
(3), or more, specific
goals
of
the
service (DO
use bullet
points):
1.
2.
3.
Value
Define
Make
foster/kinship
any changes
sure complete
families
since
and
times
original
detailed
home study
Three
(3), or more, specific
outcomes of
service:
1.
2.
3.
Foster/Kinship
That
That
foster/kinship
foster/kinship
families
feel
families
families
that
feel
feel
they
the
their
were
results
time
heard
were
was valued
clearly
accurate
and
completely
Target p •-puiation
if the
service:
1.
2.
From 18-90
Open to all
years
genders,
old,
sexual
depending
orientations,
on capability
religious
to
provide
beliefs/non-religious
for the
children
beliefs,
that
may
and
be
races.
placed
in
home.
Languages service is available
in
(please
list proficiency
and
if
interpreter services are available):
English
only
Medicaid
eligibility
—
list whether
the
service is eligible
for
Medicaid
in whole
or in
part:
REV. NOV 2019
1
ATTACHMENT C - PROPOSAL TEMPLATE
NA
Service #3 Name:
Partial Home Studies
2.3a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points):
SAFE Home Study, SAFE Interviewer, SAFE Supervisor certification
2.3b Anticipated frequency of service per week (i.e. 4 hours/week):
10 hour/ week
2.3c Anticipated duration of service (i.e. 3-4 months):
1-2 months
2.3d Three (3), or more, specific goals of the service (DO use bullet points):
2.3e
1. Encourage family if doubts about foster within the family arises
2. Address any question they may have as to why the home study was stop, if it was
3. Try to identify any issues early, so time isn't wasted
4. Write a report to WCDHS on why home study cannot move forward
Three (3), or more, specific outcomes of service:
1. Foster/Kinship families feel that they were heard clearly and completely, and encouraged if any doubts arise
2. That foster/kinship families feel the results were accurate
3. That foster/kinship families feel their time was valued
2.3f Target population of the service:
1. From 18-90 years old, depending on capability to provide for the children that may be placed in home.
2. Open to all genders, sexual orientations, religious beliefs/non-religious beliefs, and races.
2.3g Languages service is available in (please list proficiency and if interpreter services are available):
English only
2.3h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part:
NA
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 m
nths):
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:
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 #5 Name:
2.5a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points):
2e5b 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:
REV. NOV 2019
2
ATTACHMENT C - PROPOSAL TEMPLATE
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 you conduct services in your office?
3.1a If yes, office location(s):
I will work from home at 3191 e 133rdave Thornton CO 80241 and visit
families as needed in the following counties: Creek County, Gipin
County, Morgan Capable of traveling anywhere in Weld County,
Denver County, Adams County, Jefferson County, Boulder County/
Jefferson County, Clear County.
3191 e 133rd ave Thornton CO 80241
3.2 Will you conduct services out of the office?
I will conduct my work from my home
3.2a If yes, how many miles will you travel from your office?
3.3 Will you transport clients to and from services?
0
No
3.3a If yes, what is your starting point address?
NA
3.3b If yes, how many miles will you travel from your starting point address?
NA
SECTION 4 - SERVICE RATES
All rates need to include administrative work (Le., 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:
4.1a In -Office rate:
4.1b Out -of -office rate:
4.1c FTM, TDM, Prof. Staffing:
4.1d No show:
4.1e Mileage rate after catchment:
$ Amount
per
per
per
per
per
Unit Type
Mile
Catchment area in miles:
4.11 If the rate(s) listed above are a monthly package, complete the boxes below.
No. of Face-to-face hours:
No, of admin/case management hours:
No. of travel hours
TOTAL HOURS:
per month
per month
per month
per month
miles
4.2 Service #2 Name:
4.2a In -Office Rate:
4.2b Out -of -Office Rate:
4.2c FTM, TDM, Prof. Staffing:
4.2d No show:
4.2e Mileage rate after catchment:
$ Amount
per
per
per
per
per
Unit Type
Mile
Catchment area in miles:
4.2f If the rate(s) listed above are a monthly package, complete the boxes below.
No. of Face-to-face hours:
No. of admin/case management hours:
No. of travel hours
per month
per month
per month
miles
REV. NOV 2019
3
ATTACHMENT C o PROPOSAL TEMPLATE
TOTAL
HOURS:
per month
4.3 Service #3
Name:
$ Amount
Unit Type
4.3a
In -Office
Rate:
per
4.3b
Out -of
-Office
Rate:
per
Catchment
area in miles:
miles
4.3c
FTM,
TDM,
Prof.
Staffing:
per
4.3d
No show:
per
4.3e
Mileage
rate after
catchment:
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 #4
Name:
$ Amount
Unit
Type
4.4a
In
-Office
Rate:
per
4.4b
Out
-of
-Office
Rate:
per
Catchment
area in miles:
miles
4.4c
FTM,
TDM,
Prof.
Staffing:
per
4.4d
No
show:
per
4.4e
Mileage
rate
after
catchment:
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 #5
Name:
$ Amount
Unit
Type
4.5a
In
-Office
Rate:
per
4.5b
Out
-of
-Office
Rate:
per
Catchment
area in miles:
J
miles
4.5c
FTM,
TDM,
Prof.
Staffing:
per
4.5d
No
show:
per
4.5e
Mileage
rate
after
catchment:
per
Mile
4.5f
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
4.6
Home Study
Providers
—
List your
rates in the
box
below.
Service
Service
Service
submitted
Mileage
#1:
#2:
#3
beyond
to
Full
Additional
Home
Additional
Partial
WCDHS
Home
30
Study
Home
miles
Studies:
documenting
persons
persons
Updates:
Studies:
per
trip
$1250
beyond
beyond
$500
$260
why
from
two,
two
(if
home
3191
one
in
per
update
e
face-to-face
study
133'
person:
only,
cannot
Ave
$175
Thornton
per
visit
move
person:
+ two
$100
calls
forward)
CO 80241:
minimum, or
$0.56 / mile
letter
4.7
Monitored
Sobriety Providers —
List your rates in the
box
below.
NA
REV. NOV 2019
4
ATTACHMENT C - PROPOSAL TEMPLATE
Provider special notes:
REV. NOV 2019 5
STAFF DATA SHEET ATTACHMENT D
(Bidder must list all applicable staff who will manage and/or administer the proposed service. One Staff Data Sheet per proposed service. Bidder should not combine services.)
PROPOSED SERVICE OR SERVICE TYPE:
SAFE
home study
writer, interviewer, supervisor
BIDDER LEGAL ENTITY NAME (As written on W-9):
Laurice Frihauf
APPLICABLE STAFF MEMBER OR CONTRACTOR
INFORMATION
SUPERVISOR
Il�IFC?tVfATII
Previous Legal
last
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Name
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First
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Work#
Work Email
Level
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Focus
- •
(If
4I 0 C5
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applicable)
1
Frihauf
Barnett
Laurice
1-720-333-7173
Iauricefri@gmail.com
Bachelors
..:.
•
• -
—
•
NA
NA
NA
NA
NA
2
3
b
4
_
5
6
7
8
l
9
10
11
12
13
14
15
16
17
1
21
22
23
24
25
26
27
28
61800058
,4�Rv' CERTIFICATE OF LIABILITY INSURANCE DATE(MMND/YYYY)
01/08/2020
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 Simply Business
1 Beacon Street
15th Floor
Boston, MA 02108
CONTACT Simply Business
NAME:
PHONE FAX
(A(C No. Ext): (844) 654-7272 I INC, No):
emAIL
ADDRESS: contactus@simplybusiness.com
INSURERS) AFFORDING COVERAGE
NAIC #
INSURERA: Hiscox Insurance Company Inc
10200
INSURED Lau rice Frihauf
3191 E 133rd Ave
Thornton, Colorado 80241
INSURER B :
INSURER C :
INSURER D :
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.
NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDmON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE
ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF
SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR
TYPE OF INSURANCE
ADDL
INS°
SUBR
WVD
POLICY NUMBER
POLICY EFF
IMMlpgryyyY)
POLICY EXP
IMMIDD/rryn
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
Y
HIUS2578158XB
01/01/2020
01/01/2021
EACH OCCURRENCE
$1,000,000
NTED
PREMISES (ETO a occurrence)
$100,000
I
CLAIMS -MADE
X
OCCUR
MED EXP (Any one person)
$5,000
PERSONAL &ADV INJURY
$1,000,000
GENERAL AGGREGATE
$2,000,000
GEN'L
X
AGGREGATE
LIMIT APPLIES
PRO -
JECT
PER:
LOC
PRODUCTS -COMP/OPAGG
S/T Gen. Agg.
AUTOMOBILE
LIABILITY
ANY AUTO
OWNED
AUTOS ONLY
HIRED
AUTOS ONLY
-
-
R6ITIX099 ULED
NON -OWNED
AUTOS ONLY
COMBINED SINGLE LIMIT
(Ea accident)
BODILY INJURY (Per person)
BODILY INJURY (Per accident)
PROPERTY DAMAGE
(Per accident)
UMBRELLA LIAB
EXCESS LIAB
-
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
AGGREGATE
DED I J RETENTION
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANYPROPRIETORIPARTNER/EXECUTIVE
OFFICER/MEMBEREXCLUDED?
(Mandatory In NH)
It yes, describe under
DESCRIPTION OF OPERATIONS below
N
Y/N
N/A
STATUTE I I Elir14
I PER
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE
E.L. DISEASE - POLICY LIMIT
PROFESSIONAL LIABILITY
EACH CLAIM
AGGREGATE
DESCRIPTION OF OPERATIONS! LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
Additional Insured: Board of County Commissioners of Weld County and its Officers/Employees
CERTIFICATE HOLDER
CANCELLATION
Welds County
1150 O ST
Greeley, CO 80632
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
3'
-2015 ACORD CORPORATION. All ngtrts reserved.
ACORD 25 (2016103)
The ACORD name and logo are registered marks of ACORD
EXHIBIT C
SCOPE OF SERVICES
1. Contractor will conduct Home Studies, as referred by the Department.
2. Capacity for Services: 10 - 20 hours per week.
3. Contractor will conduct the following types of Home Studies:
i. Kinship Care
ii. Foster Care
iii. Kinship Foster Care
iv. Parent Care
v. Foster -Adoption
vi. Adoption
vii. Interstate Compact on the Placement of Children (ICPC)
4. Contractor is certified in Structured Analysis Family Evaluation (SAFE) and is on the State's approved home
study vendor list. Contractor also is certified as a SAFE Supervisor.
S. Contractor will utilize the most current Structured Analysis Family Evaluation (SAFE) forms and templates.
Contractor will ensure all home studies completed for the Department include, at a minimum, all the
following:
a. SAFE Home Study template.
b. Compatibility Inventory.
c. References and documented direct follow-up with references (phone call or meeting).
d. Psychosocial Inventory for all applicants.
e. Questionnaire I and II for all applicants.
f. Indian Child Welfare Act (ICWA)/Indian heritage discovery and documentation.
g. All additional collateral information collected from the applicants.
h. Urinalysis (UA) result from a certified testing facility, if requested by the Department. A UA will
be required for any individual 18 or older residing in the home, when requested by the
Department, if substance abuse concerns are noted. The cost of the UA will be responsibility of
the applicant.
6. Contractor will meet regularly with Department staff during the home study process. At a minimum,
Contractor will meet with Department staff as follows:
a. Following completion of individual applicant meetings.
b. Three (3) weeks after the completion of individual applicant meetings.
c. Prior to the final review with the applicant(s).
7. Contractor understands that reimbursement for partial home studies will only occur after the following:
a. At least one (1) face-to-face meeting and two (2) phone contacts, and
b. A letter has been submitted to the Department documenting why the study cannot move
forward.
8. Location of Services:
• In practitioner's home -based office located at 3191 East 133rd Avenue, Thornton, CO 80241.
• Services can be provided anywhere in the following counties:
o Weld
o Denver
o Adams
o Jefferson
o Boulder
o Clear Creek
o Gilpin County
o Morgan
9. Language: English only.
10. Contractor will respond to the Quality Assurance Team Supervisor (hainlejd@weldgov.com, 970-400-
6210) within three (3) business days regarding the ability to accept the received referral.
11. Upon acceptance of a referral, Contractor will offer an initial appointment within seven (7) days of
receiving the referral. The first attempt to contact the client will occur within 24 hours of receiving the
referral (excluding weekends and holidays). Contractor will document efforts to engage client in referred
services. If the client does not respond after three (3) attempts in the first seven (7) days of the referral
period, the Contractor will notify the caseworker and the Quality Assurance Team Supervisor
(hainlejd@weldgov.com, 970-400-6210).
12. 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 understands that the Department will not 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).
13. 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.
14. 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.
15. 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.
16. 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.
17. 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.
18. Contractor will notify the Quality Assurance Team Supervisor (hainlejd@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
$1,250.00/Episode (Full Home Study) —Additional charge of $175.00/per person for more than 2
participants.
$260.00/Episode (Partial Home Study)
$500.00/Episode (Home Study Update) — Additional charge of $100.00/per person for more than 2
participants.
$ .56/Mile (Mileage) — For distance exceeding thirty (30) miles from practitioner's home located at 3191
East 133rd Avenue, Thornton, CO 80241.
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
Entity Name*
FRIHAUF. LAURICE
New Contract Request
Entity ID*
@00041792
Contract Name*
FRIHAUF, LAURICE (CHILD PROTECTION AGREEMENT FOR
SERVICES)
Contract Status
CTB REVIEW
❑ New Entity?
Contract ID
3534
Contract Lead*
CULLINTA
Contract Lead Email
cullinta@comeldoo.us
Parent Contract ID
Requires Board Approval
YES
Department Project #
Contract Description*
CONSENT. BID NO. 2000037. NEW AGREEMENT FOR SERVICES. TERM 06/01120 THROUGH 05/31/20. FUNDING
CORE/OTHER
Contract Description 2
Contract Type*
AGREEMENT
Amount*
$0.00
Renewable*
YES
Automatic Renewal
Grant
IGA
Department
HUMAN SERVICES
Department Email
CM-
HumanServices@weldgov.com
Department Head Email
CM-HumanServices-
DeptHead@weldgov.com
County Attorney
GENERAL COUNTY
ATTORNEY EMAIL
County Attorney Email
CM-
COUNTYATTORNEY@WELD
GOV.COM
Requested BOCC Agenda
Date*
04/22/2020
Due Date
04//18/2020
Will a work session with BOCC be required?*
NO
Does Contract require Purchasing Dept. to be included?
If this is a renewal enter previous Contract ID
If this is part of a MSA enter MSA Contract ID
Note: the Previous Contract Number and Master Services Agreement Number should be left blank if those contracts are not in
Onaase
Contract Dates
Effective Date
Termination Notice Period
Review Date*
04/01,12021
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
04/21/2020
Final Approval
BOCC Approved
BOCC Signed Date
BOCC Agenda Date
04/29/2020
Originator
SNYDERKL
Contact Type Contact Email
Finance Approver
BARB CONNOLLY
Contact Phone 1 Contact Phone 2
Purchasing Approved Date
Finance Approved Date
04/22/2020
Tyler Ref
AG 042920
Legal Counsel
GABE KALOUSEK
Legal Counsel Approved Date
0422/2020
Submit
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