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Home My WebLink About20161890.tiff/V i) CONTRACT AGREEMENT AMENDMENT BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND TRANSITIONS PSYCHOLOGY GROUP, LLC (Core) This Agreement Amendment, made and entered into L day o 016, by and between the Board of Weld County Commissioners, on behalf of the Weld Co ty Department of Human Services, hereinafter referred to as the "Department", and Transitions Psychology Group, LLC, hereinafter referred to as the "Contractor". WHEREAS the parties entered into an Agreement for Life Skills and Mental Health Services, (the "Original Agreement") identified by the Weld County Clerk to the Board of County Commissioners as document No. 2014-3046, approved on October 6, 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 by reference herein, as well as the terms provided herein. 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 renewed for the term of June 1, 2015 -May 31, 2016. The Agreement Amendment is identified by the Weld County Clerk to the Board of County Commissioners as document No. 2014-3046, approved on May 20, 2015. • The Amendment, 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. (C) -A 150,1-€ /45 ' c21' 2016-1890 me oa87 IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first above written. COUNTY: ATTEST: dairy%) v• p'ti Weld • unt Clerk to the Board WELD COUNTY, COLORADO By: BOARD OF COUNTY COMMISSIONERS Deputy CI ;(k to the Bo1 Mike Freeman, Chair w4c3,_ JUN 2 0 2016 ransitions Psychology Group, LLC 7251 West 20th Street, Building M-2 Greeley, Colorado 80634 (970) 336-1123 By: reg Creed, Ph.D., LPC Co -Director By IIVVYM Norma Alkire, LPC Co -Director Date: SY/ —Hi (7 itua, l*fl oZo /6 - //90 OP ID: SLS Arc CERTIFICATE OF LIABILITY INSURANCE DATE(MMrDONYYY) 05/31/2016 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 Phone: 970-223-1804 Front Range Insurance Group 1100 Haxton Drive Suite 100 Fax: Fort Collins, CO 80525 David A. Wooldridge LUTCFAAI CONTACT PHONE FAX rAIa t, ). (A/C, No): E-MAIL ADDRESS: PRODUCER TRANS -6 CUSTOMER ID #: __ NAIC # 41190 INSURERS) AFFORDING COVERAGE INSURER A : Philadelphia Insurance INSURED Transitions Psychology Group, LLC 7251 W. 20th 5t, Unit M2 Greeley, CO 80634 INSURER B : Pinnacol Assurance INSURER C : INSURER D : INSURER E : INSURER F COVE 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 CONDITION 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 I -AWE-MAW LTR TYPE OF INSURANCE INSR WWI ' I POLICY EFF POLICY EXP : I POLICY NUMBER jMMIDINYYYY) IMM/OCVYYYY) ' LIMITS GENERAL A ! X i' A X A I X GEN'L X UABILITY COMMERCIAL GENERAL LIABILITY ,i CLAIMS -MADE I X i OCCUR Prof Liability Sexual Abuse X ! X i `' PHPK1500743 05/23/2016 05/23/2017 05/23/2016 05/23/201 ] j ' 05123/2016' 05/23/2017 j ' I EACH OCCURRENCE $ 1,000,000 ! DAMAGE TO RENTED PREMISES (Ea occurrence $ 100,000 FWD EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE I S 6,000 1,000,000 2,000,000 AGGREGATE LIMIT APPLIES PER: I POLICY I CT I I LOC PRODUCTS - COMP/OP AGO $ Sexual Ab IS 2,000,000 100,000 A AUTOMOBILE H--- - X X LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS X ' ( ! PHPK1500743 05123/2016 05/23/2017 : COMBINED SINGLE LIMIT I $ (Ea accident) 1,000,000 BODILY INJURY (Per person) $ $ -- --- BODILY INJURY (Per accident)! PROPERTY DAMAGE (Per accident) $ $ $ X A X UMBRELLA LIAB X EXCESS LIAB OCCUR CLAIMS -MADE � PHUB542077 05123/2016 05/23/2017 EACH OCCURRENCE AGGREGATE $ $ $ $ $ 1,000,000 1,000,000 DEDUCTIBLE RETENTION $ 10,000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY B ANY PROPRIETOR/PARTNER/EXECUTIVE Y I N ' OFFICER/MEMBER EXCLUDED? i (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A '.. X4104451 05/01/2016 05/01/2017 X . X WC STATU- ! OTH- 'TORY LIMIT5S_ __.iER. EL, EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEE $ 500,000 E.L. DISEASE - POLICY LIMIT $ 500,000 A iBus Pers Property I ,PHPK1500743 ' 05/2312016 05/23/2017 I BPP 50,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Weld County Department of Human Services is named as Additional Insured with respects to General Liability and Automobile Liability policies. A Waiver of Subrogation applies to General Liability policy. A provision that coverage is non-contributory with other coverage or self insurance provided by county. CERTIFICATE HOLDER CANCELLATION Weld County Department of Human Services 315 A N. 11th Avenue 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 ACORD 25 (2009/09) © 1988-2009 ACORD CORPORATION. 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