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Home My WebLink About20162558.tiff,06/\Ayosi AA -G5 CONTRACT AGREEMENT AMENDMENT BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND LEAHY NEUROFEEDBACK DBA DENVER NEUROFEEDBACK (Core) This Agreement Amendment, made and entered into O day of 2016, by and between the Board of Weld County Commissioners, on behalf of the Weld Coun Department of Human Services, hereinafter referred to as the "Department", and Leahy Neurofeedback DBA Denver Neurofeedback. hereinafter referred to as the "Contractor". WHEREAS the parties entered into an Agreement for Mental Health Services (Neurofeedback] (the "Original Agreement") identified by the Weld County Clerk to the Board of County Commissioners as document No. 2014-2476, approved on August 11, 2014. WHEREAS the parties hereby agree to amend the term of the Original Agreement in accordance with the terms of the Original Agreement, which is incorporated ey reference herein, as well as the terms proviaea nerein. NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows: • The Original Agreement ended on May 31, 2015. • The Original Agreement was amended for an additional term of June 1, 2015 -May 31, 2016. This Agreement Amendment is identified by the Weld County Clerk to the Board of County Commissioners as document No. 2014-2476(1), approved on May 20, 2015. • The Amendment(s), together with the Original Agreement, constitutes the entire understanding between the parties. The following change is hereby made to the Contract Documents: 1. Term This agreement shall become effective on June 1, 2014, upon proper execution of this Agreement and shall expire May 31, 2017, unless sooner terminated as provided herein. 2. None • All other terms and conditions of the Original Agreement remain unchanged, 671)Set,W 45D 2016-2558 4-4Z tor4- IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first above written. COUNTY: ATTEST: dor444)p.ei We •unto Clerk to the Board WELD COUNTY. COLORADO BOARD OF COUNTY COMMISSIONERS By. Deputy s''erk to the : ��.,�_ Mike Freeman. Chair AUG 0 8 2 eahy Neurofeedback DBA Denver Neurofeedback 6640 South Yukon Way Loioraao uu123 (720) 384-6018 By:...../.4,441-/ ,`J` Date: Susan G. Leahy. OMC ,�ZO/� - a. 5-5tr ACORL® CERTIFICATE OF LIABILITY INSURANCE ‘.....------ DATE(MMIDDIYYYY) 06/22/2016 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 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 Jolene Johnson(0715306) CONTACT Jolene Johnson NAME: 1 FAX P/C,NN , Ext): 303-768-8130 1 (aC No 303-708-1263 14 Inverness Dr E Ste B232 E-MAIL AODREss: jjQhnson8t�farmersaggnt.gom INSURER(S) AFFORDING COVERAGE NAIC # Englewood CO 80112-5619 INSURERA: Truck Insurance Exchange 21709 INSURED INSURER B : Farmers Insurance Exchange 9--- 21652 Denver Neurofeedback -- INSURER C : Mid Century Insurance Company 21687 6640 S Yukon Way INSURER D : Hiscox/Underwriters At Lloyd's, London INSURER E : Littleton CO 80123 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 INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. -_----- PERIOD THIS TERMS, ILT R� 'ADDL NSR LTR TYPE OF INSURANCE SWVD POLICY NUMBER IMM/DOPOLICY IYYYY) ' (MM/DD/YYYY) ! LIMITS D ' GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY ! ! I 1245535.15 12/01/2013 I 12/01/2016 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED ! PREMISES (Ea occurrence) ' $ CLAIMS -MADE X OCCUR MED EXP (Any one person) $ X J GEN'L X Professional Liability y PERSONAL aAovINJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: 1 PRO- POLICY 1 '! JECT !I LOC GENERAL AGGREGATE $ $ 3,000,000 ' PRODUCTS - COMP/OP AGG $ AUTOMOBILE -I! LIABILITY ANY AUTO SCHEDULED I ALL OWNED I AIRED AUTOS ! ! I,, !. COMBINEDSINGLE LIMIT $ BODILY INJURY (Per person) — $ - c _..--- BODILY INJURY (Per accident) $ PROPERTY DAMAGE F (Per accident) t $ f. UMBRELLA LIAB OCCUR IAB CLAIMS -MADE ' EXCESS LIAB i j �, EACH OCCURRENCE AGGREGATE $ ! DED j RETENTION $ $ WORKERS AND ANY OFFICER/MEMBER (Mandatory If yes, DESCRIPTION COMPENSATION EMPLOYERS' LIABILITY YIN N /A WC STATU- I OTH-. y CRY IT ER - - - _ $ ------- $ -- -- - - E.L. EACH ACCIDENT PROPRIETOR/PARTNER/EXECUTIVE EXCLUDED? - +-- F -- E E.L. DISEASE - EA EMPLOYEE', - _ - in NH ) describe under OF OPERATIONS below E.L. DISEASE - POLICY LIMIT ! $ DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) P 4 ) Additional Insured- Weld County Professional Liability CERTIFICATE HOLDER CANCELLATION Weld County 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 Jolene Johnson ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Hello