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Home My WebLink About20162769.tiffEXHIBIT A WELD COUNTY'S REQUEST FOR PROPOSAL Bid No. B1600049 BOARD OF COUNTY COMMISSIONERS OF THE COUNTY OF WELD, STATE OF COLORADO, BY AND THROUGH THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES DATE: MARCH 9, 2016 PAGES 1-4 OF THIS REQUEST FOR PROPOSAL CONTAIN GENERAL INFORMATION. NOT ALL OF THE INFORMATION CONTAINED IN PAGES 1-4 MAY BE APPLICABLE. SPECIFICATIONS UNIQUE TO THIS REQUEST FOR PROPOSAL FOLLOW PAGE 4. NOTICE TO BIDDERS A. The Families, Youth and Children's Commission, on behalf of the Weld County Department of Human Services, by and through the Board of Weld County Commissioners, wishes to purchase the following: MONITORED SOBRIETY SERVICES (SOUTH WELD COUNTY) B. Bids for the stated services will be received by the Weld County Department of Human Services, Resource Unit, Attn: Tobi Vegter at vegterta@weldgov.com or P.O. Box A, 315 A North 11th Avenue, Greeley, CO 80631, through: FRIDAY, MARCH 25, 2016, AT 5:00 P.M. (WELD COUNTY DEPARTMENT OF HUMAN SERVICES, RESOURCE UNIT TIME CLOCK). II. INVITATION TO BID A. The Families, Youth and Children's Commission, on behalf of the Weld County Department of Human Services, by and through the board of Weld County Commissioners requests bids for the purchase of MONITORED SOBRIETY SERVICES (SOUTH WELD COUNTY) B. Bids shall include any and all charges for service(s) applied for by the bidder, and shall, in every way, be the total net price which the bidder will expect the Board of County Commissioners of Weld County to pay if awarded the bid. C. Emailed Bids Are Preferred. Emailed (fully typed) bids are preferred. However, if the bidder is unable to submit an emailed bid, the bidder must comply with the requirements set forth in Paragraph II D below. An emailed bid must contain the following statement: "I hereby waive my right to a sealed bid." D. Unless the Bid is emailed, one original and one copy of the Bid must be submitted. One complete bid document, which will be the only official copy of the bid, shall be filed at the Weld County Department of Human Services, Resource Unit. After certification of the bid, the other copy will be routed for applicable review. An e-mail confirmation will be sent when we receive your bid/proposal. Page 1 2016-2769 14-/ NIZOOg1 Bid No. 81600049 III. INSTRUCTIONS TO BIDDERS A. Bids shall be typewritten. Each bid must give the full business address of the bidder and be signed by him with his usual signature. Bids by partnerships must furnish the full names of all partners and must be signed with the partnership name by one of the partners of the partnership or by an authorized representative, followed by the signature and title of the person signing. Bids by corporations must be signed with the legal name of the corporation, followed by the name of the state of the incorporation and by the signature and title of the president, secretary, or other person authorized to bind it in this matter. Bids submitted by limited liability companies must furnish the full names of all members and managers and must be signed by a manager or by an authorized representative, followed by the signature and title of the person signing. The name of each person signing shall also be typed or printed below the signature. A bid by a person who affixes to his signature the word "president," "secretary," "agent," or other title without disclosing his principal, may be held to be the bid of the individual signing. When requested, satisfactory evidence of the authority of the officer signing in behalf of a corporation shall be furnished. All corrections or erasures shall be initialed by the person signing the bid. All bidders shall agree to comply with all of the conditions, requirements, specifications, and/or instructions of this bid as stated or implied herein. All designations and prices shall be fully and clearly set forth. B. Bids may be withdrawn upon written request to the Weld County Department of Human Services received from bidders prior to the submission deadline. Negligence on the part of bidder in preparing the bid confers no right for the withdrawal of the bid after it has been opened. C. Bidders are expected to examine the conditions, specifications, and all instructions contained herein. Failure to do so will be at the bidder's risk. D. Bidders shall not stipulate in their proposals any conditions not contained in the instructions and specifications herein unless specifically requested by the special instructions attached hereto. Any proposal which fails to comply with the letter of the instructions and specifications herein may be rejected. E. Late or unsigned bids shall not be accepted or considered. It is the responsibility of the bidder to ensure that the bid arrives in the Weld County Department of Human Services, Resource Unit, on or prior to the time indicated in Section I., entitled "Notice to Bidders." F. When approximate quantities are stated, Weld County reserves the right to increase or decrease quantity as best fits its needs. G. Whenever requested, samples or descriptive matter shall be filed prior to the opening of bids. H. In accordance with Section 14-9(3) of the Weld County Home Rule Charter, the Board of County Commissioners of Weld County will give preference to resident Weld County bidders in all cases where said bids are competitive in price and quality. It is also understood that the Board of County Commissioners of Weld Page 2 Bid No. B1600049 County will give preference to suppliers from the State of Colorado, in accordance with Section 30-11-110, CRS, when it is accepting bids for the purchase of any books, stationery, records, printing, lithographing or other supplies for any officer of Weld County. All discounts shall be figured from the date of delivery and acceptance of the articles, or in the case of an incorrect invoice, from the date of receipt of corrected invoice, if this be subsequent to delivery and acceptance. J. Substitutions or modifications to any of the terms, conditions, or specifications of this bid package which are made by Weld County, Colorado, after the bids have been distributed to prospective bidders, and prior to the date and time of bid opening, will be made in writing and signed by the Families, Youth and Children's Commission. No employee of Weld County, Colorado, is authorized in any way to modify any of the terms, conditions, or specifications of this bid without written approval of Families, Youth and Children's Commission. This is not to imply that bids will not be accepted or considered with specifications which are different from those herein. Any item which does not meet all the terms, conditions, or specifications of this bid, must be clearly indicated on a separate sheet of paper, attached to the bid specification and proposal sheets and returned with the bid. K. The successful bidder shall indemnify and hold harmless Weld County, Colorado, against all claims for royalties, for patents or suit for infringement thereon, which may be involved in the manufacture or use of the material to be furnished. L. Successful bidder certifies, warrants, and agrees that it does not knowingly employ or contract with an illegal alien who will perform work under this contract. Successful bidder 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). Successful bidder 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 Successful bidder that the subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this Agreement. Successful bidder 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 Successful bidder obtains actual knowledge that a subcontractor performing work under the public contract for services knowingly employs or contracts with an illegal alien Successful bidder shall notify the subcontractor and County within three (3) days that Successful bidder 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. Successful bidder 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 Page 3 Bid No. 81600049 an illegal alien. Successful bidder 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 Successful bidder participates in the State of Colorado program, Successful bidder shall, within twenty days after hiring a new employee to perform work under the contract, affirm that Successful bidder 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. Successful bidder shall deliver to County, a written notarized affirmation that it has examined the legal work status of such employee, and shall comply with all of the other requirements of the State of Colorado program. If Successful bidder fails to comply with any requirement of this provision or of C.R.S. §8-17.5-101 et seq., County, may terminate this Agreement for breach, and if so terminated, Successful bidder shall be liable for actual and consequential damages. Except where exempted by federal law and except as provided in C.R.S. § 24- 76.5-103(3), if Successful bidder receives federal or state fundsunder the contract, Successful bidder 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 Successful bidder 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. M. All goods shall remain the property of the seller until delivered to and accepted by Weld County, Colorado. N. Late or unsigned bids shall not be accepted or considered. Bids received prior to the time of opening will be kept unopened in a secure place. No responsibility will attach to the Families, Youth and Children Commission, the Weld County Department of Human Services, or the Board of Weld County Commissioners, for the premature opening of a bid not properly addressed and identified. O. In submitting the bid, the bidder agrees that the acceptance of any and all bids by the Board of County Commissioners of Weld County within a reasonable time or period does not constitute a contract. The Board of County Commissioners of Weld County, Colorado, reserves the right to reject any and 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. Page 4 Bid No. B1600049 P. These instructions, the proposal forms, and specifications have been developed with the hope of raising the standard of purchasing negotiations to a level wherein all transactions will be mutually satisfactory. Your cooperation is invited. Q. Substitutions or modifications to any of the terms, conditions, or specifications of this which are made by Weld County after the bids have been distributed to prospective bidders and prior to the date and time of bid opening, will be made in writing. No employee of Weld County is authorized in any way to modify any of the terms, conditions, or specifications of this bid without written approval of said Director of the Weld County Department of Human Services. This is not to imply that bids will not be accepted or considered with specifications which are different from those herein. Any item which does not meet all the terms, conditions, or specifications of this bid, must be clearly indicated on a separate sheet of paper, attached to the bid specification and proposal sheets and returned with the bid. IV. General Specifications. A. Fund Availability: Financial obligations of the Weld County payable after the current fiscal year are contingent upon funds for that purpose being appropriated, budgeted and otherwise made available. By acceptance of the bid, Weld County does not warrant that funds will be available to fund the contract beyond the current fiscal year. B. Confidential Information: Confidential financial information of the bidder should be transmitted separately from the main bid submittal, clearly denoting in red on the financial information at the top the word, and "CONFIDENTIAL." However, the successful bidder is advised that as a public entity, Weld County must comply with the provisions of C.R.S. 24-72-201, et seq., with regard to public records, and cannot guarantee the confidentiality of all documents. C. Governmental Immunity: No term or condition of the contract shall be construed or interpreted as a waiver, express or implied, of any of the immunities, rights, benefits, protections or other provisions, of the Colorado Governmental Immunity Act §§24-10-101 et seq., as applicable now or hereafter amended. D. Independent Contractor: The successful bidder shall perform its duties hereunder as an independent contractor and not as an employee. He or she shall be solely responsible for its acts and those of its agents and employees for all acts performed pursuant to the contract. Neither the successful bidder nor any agent or employee thereof shall be deemed to be an agent or employee of Weld County. The successful bidder and its employees and agents are not entitled to unemployment insurance or workers' compensation benefits through Weld County and Weld County shall not pay for or otherwise provide such coverage for the successful bidder or any of its agents or employees. Unemployment insurance benefits will be available to the successful bidder and its employees and agents only if such coverage is made available by the successful bidder or a third party. The successful bidder shall pay when due all applicable employment taxes and income taxes and local head taxes (if applicable) incurred pursuant to the contract. The successful Page 5 Bid No. B1600049 bidder shall not have authorization, express or implied, to bind Weld County to any agreement, liability or understanding, except as expressly set forth in the contract. The successful bidder 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 (b) provide proof thereof when requested to do so by Weld County. E. Compliance with Law: The successful bidder shall strictly comply with all applicable federal and State laws, rules and regulations in effect or hereafter established, including without limitation, laws applicable to discrimination and unfair employment practices. F. Choice of Law: Colorado law, and rules and regulations established pursuant thereto, shall be applied in the interpretation, execution, and enforcement of the contract. Any provision included or incorporated herein by reference which conflicts with said laws, rules and/or regulations shall be null and void. G. Binding Arbitration Prohibited: Weld County does not agree to binding arbitration by any extra -judicial body or person. Any provision to the contrary in the contract or incorporated herein by reference shall be null and void. H. No Third Party Beneficiary Enforcement: It is expressly understood and agreed that the enforcement of the terms and conditions of the contract, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties and nothing in the contract shall give or allow any claim or right of action whatsoever by any other person not included in the contract. It is the express intention of the undersigned parties that any entity other than the undersigned parties receiving services or benefits under the contract shall be an incidental beneficiary only. Attorneys Fees/Legal Costs: In the event of a dispute between Weld County and the successful bidder, concerning the contract, the parties agree that Weld County shall not be liable to or responsible for the payment of attorney fees and/or legal costs incurred by or on behalf of the successful bidder. J. Procurement and Performance: The successful bidder agrees to procure the materials, equipment and/or products necessary for the project and agrees to diligently provide all services, labor, personnel and materials necessary to perform and complete the project. The successful bidder shall further be responsible for the timely completion, and acknowledges that a failure to comply with the standards and requirements outlined in the Bid within the time limits prescribed by County may result in County's decision to withhold payment or to terminate this Agreement. K. Term: The term of this Agreement begins upon the date of the execution of this Agreement by County, and shall continue for three years. However, the agreement must be renewed by both parties, in writing, on an annual basis. Page 6 Bid No. B1600049 L. Termination: County has the right to terminate this Agreement, with or without cause on thirty (30) days written notice. Furthermore, this Agreement may be terminated at any time without notice upon a material breach of the terms of the Agreement. M. Subcontractors: The successful bidder acknowledges that County has entered into this Agreement in reliance upon the particular reputation and expertise of the successful bidder. The successful bidder shall not enter into any subcontractor agreements for the completion of this Project without County's prior written consent, which may be withheld in County's sole discretion. N. Non -Assignment: The successful bidder may not assign or transfer this Agreement or any interest therein or claim thereunder, without the prior written approval of County. Any attempts by the successful bidder to assign or transfer its rights hereunder without such prior approval by County shall, at the option of County, automatically terminate this Agreement and all rights of the successful bidder hereunder. Such consent may be granted or denied at the sole and absolute discretion of County. O. Insurance Requirements. i. General Requirements: Contractors/Contract Professionals 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/Contract Professionals 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, County must be notified by the Contractor/Contract Professional. Contractor/Contract Professional shall be responsible for the payment of any deductible or self -insured retention. County reserves the right to require Contractor/Contract Professional to provide a bond, at no cost to County, 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/Contract Professional. Contractor/Contract Professional 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. Page 7 Bid No. B1600049 ii. Types of Insurance: Contractor/Contract Professional shall obtain, and maintain at all times during the term of any Agreement, insurance in the following kinds and amounts: (a). Workers' Compensation Insurance as required by state statute, and Employer's Liability Insurance covering all of Contractor's Contract Professional'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. (b). 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. (c). Automobile Liability: Contractor/Contract Professional 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. (d). Additional Provisions: * Policies for all general liability, excess/umbrella liability, liquor liability and pollution liability must provide the following: * If any aggregate limit is reduce by twenty-five percent (25%) or more by paid or reserved claims, Contractor shall notify County 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 County. Page 8 Bid No. B1600049 (e). 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 County, whichever is earlier. iii. Contractors/Contract Professionals 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. iv. Proof of Insurance: Contractor/Contract Professional shall provide a copy of this information to its insurance agent or broker, and shall have its agent or broker provide proof of Contractor/Contract Professional's required insurance to the County. County reserves the right to require Contractor/Contract Professional 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. v. Additional Insureds: For general liability, excess/umbrella liability, pollution legal liability, liquor liability, and inland marine, Contractor/Contract Professional's insurer shall name County as an additional insured. vi. Waiver of Subrogation: For all coverages, Contractor/Contract Professional's insurer shall waive subrogation rights against County. vii. Subcontractors: All subcontractors, 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/Contract Professional. Contractor/Contract Professional 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/Contract Professional agrees to provide proof of insurance for all such subcontractors, independent contractors, sub -vendors suppliers or other entities upon request by the County. Page 9 Bid No. B1600049 A provider of Professional Services (as defined in the Bid or RFP) shall provide the following coverage: Professional Liability: Contract Professional shall maintain limits of $1,000,000 for each claim, and $2,000,000 aggregate limit for all claims. V. Warranty. The successful bidder shall warrant that: A. The services to be supplied pursuant to this bid are fit and sufficient for the purpose intended; B. The services sold to Weld County, Colorado pursuant to this bid conform to the minimum Weld County specifications as established herein. Page 10 Bid No. B1600049 Project Overview: The Weld County Department of Human Services (WCDHS) is seeking qualified monitored sobriety services in southern Weld County, with services available in one or more of the following primary communities: Fort Lupton, Frederick, Firestone, Dacono, Keenesburg, Lochbuie, Erie, and Longmont. Qualifications: To be considered, a bidder must meet the following minimum qualifications: 1) A bidder must demonstrate ability, knowledge and competency to provide monitored sobriety services to both male and female clientele, who utilize a variety of substances. Prior experience with Child Welfare clientele is preferred, as well as ability to provide less common testing options such as Hair Follicle testing and Patch monitoring in addition to standard Urinalysis and Breathalyzer testing. 2) A bidder must submit a written protocol that clearly outlines collection procedures, monitoring standards, observation, chain of custody, lab procedures, reporting, and other pertinent policies and/or procedures. 3) Bidder must demonstrate capacity to successfully administer a randomization process for monitored sobriety. Bidder should provide sufficient information regarding Bidder's randomization process for Weld County to clearly understand the process used. 4) A bidder must submit a one page or less cover letter that introduces the bidder, the bidder's location(s) of practice and target area, his or her experience and qualifications, and staff, if applicable. A bidder must include current contact information including physical address, mailing address, phone number, email address and website, if applicable. 5) A bidder must submit sufficient information concerning each proposed service for Weld County to evaluate whether or not the bidder meets "minimum qualifications" for all • bidders. 6) Bidders should avoid elaborate artwork, graphics, binding, presentation or other artifice that does not directly address the requirements set forth in this Request for Proposal. Page 11 Bid No. B1600049 7) A bidder must demonstrate the knowledge, training and expertise to conduct the proposed service(s). 8) A bidder must provide a current resume, as well as proof of licensure, for self and staff members. 9) Bidder should clearly outline the supervisory structure of staff members and/or contractors of the bidder. This should include the ratio of supervisor to staff and/or contractors, frequency and duration of supervision, credentials of supervisor and length of time as a supervisor. 10) A bidder must demonstrate prior and current capacity to be organized, responsive and to quickly and successfully schedule services as requested. 11) A bidder must agree to enter into a contract, attached as Exhibit A, with the Weld County Department of Human Services and comply with all requirements of the contract. Contract Period and Pricing: 1) The initial contract period is to be determined and shall continue as allowable by the funding source, so long as both parties are satisfied. The selected vendor(s) will have the opportunity to resubmit annually. 2) The initial contract will be funded through Core Services Program or Child Welfare Administration funding, so long as funding is made available. 3) The selected vendor will bill the Weld County Department of Human Services monthly according to billing requirements set forth by the Weld County Department of Human Services. Submittal Requirements for All Proposals: A bidder must submit according to requirements set forth in this Request for Proposal. All proposals must contain the following specific information: 1) Demonstrate ability, knowledge and competency to provide monitored sobriety services to both male and female clientele, who utilize a variety of substances. Prior experience Page 12 Bid No. B1600049 with Child Welfare clientele is preferred. 2) Include a written protocol that clearly outlines collection procedures, monitoring standards, observation, chain of custody, lab procedures, reporting, and other pertinent policies and/or procedures. 3) One page or less cover letter that introduces the bidder, the bidder's location(s) of practice, his or her experience and qualifications, and staff, if applicable. 4) Sufficient information concerning each proposed service for Weld County to evaluate whether or not the bidder meets "minimum qualifications" for all bidders. 5) Bidders should avoid elaborate artwork, graphics, binding, presentation or other artifice that does not directly address the requirements set forth in this Request for Proposal. 6) Current resume, proof of licensure and copies of applicable training certificates for all staff members who will manage and/or administer services under this proposal. 7) Supervisory structure of staff members and/or contractors of the bidder. This should include the ratio of supervisor to staff and/or contractors, frequency and duration of supervision, credentials of supervisor and length of time as a supervisor. 8) All proposals must demonstrate the bidder has the ability to deliver the services as proposed, and comply with the specific requirements set forth by the Weld County Department of Human Services. 9) All proposals must include a clear and concise rate schedule that accurately correlates to the proposed services and is inclusive of all possible charges related to the proposed service(s). Bidders should consider rates for partial home studies, full home studies, and home study updates, as well as rates for associated costs of doing business. The rate schedule must demonstrate an exact fee for each described service (s). Approximate rates or a range of rates for a service will not be considered. 10) Each bidder must submit a Standard Certificate of Insurance, or letter of intent from an insurance company authorized to do business in the State of Colorado stating its willingness to insure the bidder pursuant to the terms of this Request for Proposal. Page 13 Bid No. B1600049 Evaluation of Proposals: All proposals that meet the basic proposal, service and qualification requirements will be reviewed by the Families, Youth and Children (FYC) Commission. The FYC Commission will make recommendations to the Board of Weld County Commissioners by and through the Weld County Department of Human Services. The Weld County Department of Human Services will make its award of contract to the successful bidders upon final approval of the Board of Weld County Commissioners. Page 14 EXHIBIT A CHILD PROTECTION AGREEMENT FOR SERVICES BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND This Agreement, made and entered into the _ day of 2016 by and between the Board of Weld County Commissioners, on behalf of the Weld County Department of Human Services, hereinafter referred to as the "Department' and «Contractor», 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 Proposal, Exhibit C, Scope of Services, and Exhibit D, Payment Schedule. Each of these documents is attached hereto and incorporated herein by this reference. WITNESSETH WHEREAS, required approval, clearance, and coordination have been accomp ished from and with appropriate agencies; and WHEREAS, the Colorado Department of Human Services has provided fun 'ng to the Department for NOW THEREFORE, in consideration of the premises, the part c�Et venant and agree as follows: 1. Term This agreement shall become effective on , upon ... - :` ecution of this Agreement and shall expire unless sooner terminated as pro ' d herein.e agreement is for a period of three years. However, the agreement must be renewed o ljiarties, in writing, on an annual basis. 2. Scope of Services Services shall be provided by the d. rtor t8 any person(s) eligible for services in compliance with Exhibit B, Contractor's Proposa1F • ibit C, Scope of Services. 3. Referrals Billin a. Contrac unBe�r f nerds and will comply with all aspects of the referral authorization, billing and tracking r ire �[� as set forth by the Department. Failure to comply with all aspects may result in a forfei p ment. 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 Department's Resource Manager, Child Welfare Contract and Services Coordinator, or through a Team Decision Making (TDM) meeting or Family Team Meeting (FTM). No other Department staff or other party to the case may authorize services or modifications to services. c. Contractor agrees to submit an itemized complete billing statement by the 7th of the month, following the month of service, utilizing billing forms required by the Department. 1 d. Contractor agrees to submit a monthly report with the billing statement by the 7th of the month following the month of service for each client receiving ongoing services. One-time services will be verified through receipt of the completed product (ex. psychological evaluation, substance abuse evaluation). Verification of Monitored Sobriety Services will be the test result. 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. Monthly reports will be submitted through the Department's online reporting system, unless otherwise directed or agreed to by the Department. 4. Payment a. The Department and the Contractor agree that all benefits from pri to insurance and/or other funding sources such as Medicaid (if Contractor is a Medicaid eligib der) or Victim's Compensation must be exhausted before Core Services or other Departme funds can be accessed for services. b. Payment shall be made in accordance with Exhibit A, B, Contractor's Proposal, Exhibit C, Scope of Service hereto and incorporated herein by reference, so lo accordance with the Agreement. bpty's Request for Proposal, Exhibit it D, Payment Schedule, attached s are rendered satisfactorily and in c. Payment pursuant to this Agreeme w er in whole or in part, is subject to, and contingent upon, the continuing availability of said fun foe purposes hereof. d. The Department may with the Agreement, including the terms, or reporting require appeal such circumstn4e in of Human Services sha ement if Contractor has failed to comply with any part of agement requirements, program objectives, contractual In the event of forfeiture of reimbursement, Contractor may o the Director of Human Services. The decision of the Director At all times fro �,, `e ei'.ective date of the Agreement until completion of the Agreement, Contractor shall comply with the a.n,' istrative 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 0MG Circular A-133. 6. Payment Method Unless otherwise provided in Exhibit B, Contractor's Proposal, Exhibit C, Scope of Services, and Exhibit D, Payment 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 an ACH Form for Colorado Providers, which will be provided by the Department. Contractor is solely responsible to submit the ACH Form to the State of 2 Colorado per the directions on the form. Failure to complete and submit this form 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 20 d-1 Title VI of the Civil Rights Act of 1964, 42 U.S.C. Sections 2000d-1 et. seq. andementing regulation, 45 C.F.R. Part 80 et. seq.; and all provisions of the Civil Rights Act of 1986 so th race, creed, color, sex, or national origin, be ex$ benefits of, or be otherwise subjected to d; - Section 504 of the Rehabilitation Act implementing regulations, 45 C.F.gftart 84; a In shall, on the grounds of participation in, be denied the under the approved Agreement. 9 U.S.C. Section 794, and its - the Age Discrimination Act o 75 '1 U.S.C. Section 6101 et. seq. and its implementation regulatiorsP�4S C.F. art 91; and - Title VII of the is AFf of 1964; and - the Age ' cri o in Employment Act of 1967; and the a Pa ct of 1963; and Cation Amendments of 1972; and gration 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. 3 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 Core Services. 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 Agreem nt, been convicted of or had a civil judgment rendered against them for commission of fr ud or criminal offense in connection with obtaining, attempting to obtain, or perfor ublic (Federal, State or Local) transaction or contract under public transaction• violation o deral or state antitrust statutes or commission of embezzlement, theft, forggr ribery, falsification or destruction of records, making false statements, or receiving stol p y; and are not presently indicted for or othe se ally or civilly charged by a government entity (federal, state or local) with commi ion o ny f the offenses enumerated in this certification; and - have not, within a three -ye d preceding this Agreement, had one or more public transactions (federal, state, or lot tern$ hated for cause or default. e. Public Contracts for Sery R7.5-101. Contract Professional certifies, warrants, and agrees that it does not knowi ploy r contract with an illegal alien who will perform work under this contract. Contract Pro i I will confirm the employment eligibility of all employees who are newly hired for empl e i h United States to perform work under this Agreement, through participation in the E- r gram or the State of Colorado program established pursuant to C.R.S. §8-17.5-102(5)(c . ra rofessional shall not knowingly employ or contract with an illegal alien to perform wor un i greement or enter into a contract with a subcontractor that fails to certify with Cont t r e onal that the subcontractor shall not knowingly employ or contract with an illegal alien to p r under this Agreement. Contract Professional shall not use E -Verify Program or State of Color rogram procedures to undertake pre -employment screening or job applicants while this Agreement is being performed. If Contract Professional obtains actual knowledge that a subcontractor performing work under the public contract for services knowingly employs or contracts with an illegal alien Contract Professional shall notify the subcontractor and County within three (3) days that Contract Professional 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. Contract Professional 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. Contract Professional shall comply with reasonable requests made in the course of an investigation, undertaken pursuant to C.R.S. 48-17.5-102(5), by the Colorado Department of Labor and Employment. If Contract Professional participates in the State of Colorado program, Contract Professional shall, within twenty days after hiring a new employee to perform work under the contract, affirm that Contract Professional 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. Contract Professional shall deliver to County, a written notarized affirmation that it has examined the legal work status of such employee, 4 and shall comply with all of the other requirements of the State of Colorado program. If Contract Professional fails to comply with any requirement of this provision or of C.R.S. §8-17.5-101 et seq., County, may terminate this Agreement for breach, and if so terminated, Contract Professional shall be liable for actual and consequential damages. 1. Except where exempted by federal law and except as provided in C.R.S. § 24-76.5-103(3), if Contract Professional receives federal or state funds under the contract, Contract Professional 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 Contract Professional 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 out es in three areas; Safety, Permanency and Well Being of families. For each outcom itht andigerformance indicators measure each state's performance according to national standard oor progress over time. Following the review, a Program Improvement Plan (PIP) willted for the state to enhance services to families. Contractor agrees to continually strive for positive outche areas of Safety, Permanency and Well Being. Contractor will ensure that any employ or subcon actor of Contractor providing services under this Agreement will work towards positive o o in the aforementioned three areas as outlined under the Child and Family Services Review (CFSR), an ill dress the aforementioned three areas when completing monthly reports as require3(d) of this Agreement. 9. Insurance Re. uirements Contractor and Departme.,l, -gre= �4LWeld County, the Board of County Commissioners of Weld County, its officers and employees, be held liable for injuries or damages caused by any negligent acts or omissions of the Con o bcontractor, or their employees, volunteers, or agents while performing duties described i thi a ent. Contractor shall indemnify, defend and hold harmless Weld County, the Board of C ssioners of Weld County, its employees, volunteers and agents. Contractor shall pmdde 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, the following insurance coverage. Weld County, State of Colorado, by and through the Board of County Commissioners of Weld County, its employees and agents, shall be named as additional named insured on the insurance, where permissible the insurance provider. a. General Requirements: Contractors/Contract Professionals 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/Contract Professionals shall keep the required insurance coverage in force at all times during the term of 5 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, County must be notified by the Contractor/Contract Professional. Contractor/Contract Professional shall be responsible for the payment of any deductible or self -insured retention. County reserves the right to require Contractor/Contract Professional to provide a bond, at no cost to County, 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/Contract Professional. Contractor/Contract Pr fessional shall maintain, at its own expense, any additional kinds or amounts of insurance that if may deem necessary to cover its obligations and liabilities under this Agreement. b. Types of Insurance: Contractor Contract ProfeJ�lc shal�ll btain, and maintain at all times during the term of any Agreement, insurance in the"fi2 j ing''kinds and amounts: Workers' Compensation Insu Liability Insurance covering all of Con within the course and scope of their Contractor, as defined by the shall not apply. Contractor Contractor Status Form prior ii. Commer 0110/93 or e Contractors, injury, aadv tf* quired by state statute, and Employer's OsttractProfessional's employees acting nt. If Contractor is an Independent orado .`r er's Compensation Act, this requirement tbmit to the Department a Declaration of Independent art of this agreement. lability Insurance written on ISO occurrence form CG 00 covering premises operations, fire damage, independent and completed operations, blanket contractual liability, personal ability 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. Automobile Liability: Contractor/Contract Professional 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 reduce by twenty-five percent (25%) or more by paid or reserved claims, Contractor shall notify County 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 County. 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 County, whichever is earlier. c. Contractors/Contract Professionals 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, incl ding public liability and property damage, in form and company acceptable to and approve y said Administrator, covering all operations hereunder set forth in the related Bid o st for Proposal. d. Proof of Insurance: Contractor/Contract Profes, information to its insurance agent or broker, and shall ha Contractor/Contract Professional's required insuran Contractor/Contract Professional to provide a insurance as required by the County's Risk Ad rovide a copy of this or broker provide proof of eserves the right to require insurance, a policy, or other proof of his sole discretion. e. Additional Insureds: For gengra"T liability, Tccess/umbrella liability, pollution legal liability, liquor liability, and inland marine, C an additional insured as follows f. Waiver of Subro shall waive subrogation r/Contract Professional's insurer shall name County as a aan Fr�r Ig JiZoverages, Contractor/Contract Professional's insurer ams County. R. Subcont or b I�s :contractors, subcontractors, independent contractors, sub - vendors, suppliers entities providing goods or services required by this Agreement shall be subject t th quirements herein and shall procure and maintain the same coverages required f C c /Contract Professional. Contractor/Contract Professional shall include all such co a - ors, independent contractors, sub -vendors suppliers or other entities as insureds unde oli or shall ensure that all subcontractors maintain the required coverages. Contract w ntract Professional agrees to provide proof of insurance for all such subcontractors, independent contractors, sub -vendors suppliers or other entities upon request by the County. A provider of Professional Services (as defined in the Bid or RFP) shall provide the following coverage: Professional Liability: Contract Professional 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 7 Contractor may be required to attend training that 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 970-352-1551, x6503, and advise that the subpoena must be personally served. 13. Monitoring and Evaluation Contractor and the Department agree that monitoring and evaluation o Agreement shall be conducted by the Contractor and the Department. The res evaluation shall be provided to the Board of Weld County Commi. Contractor. Contractor shall permit the Department, and any other monitor all activities conducted by the Contractor purs monitoring agency may in its sole discretion deem nece analyses, on -site checking, formal audit examing tons, or a monitoring shall be performed in a manner t this Agreement. rformance of this of the monitoring and Department and the ,zed agent or governmental agency, to e terms of this Agreement. As the ppropriate, such program data, special other reasonable procedures. All such not unduly interfere with the work conducted under 14. Modification of Agreemen All modifications to this Agreelit be in writing and signed by both parties. 15. Remedies \® The Director of Human the Contracto failure to satis the Contractor. T or designee may exercise the following remedial actions should s/he find �ly failed to satisfy the scope of work found in this Agreement. Substantial pe of work shall be defined to mean incorrect or improper activities or inaction by 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. 8 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, Administrator 17. Notice For Contractor: CONTRACTOR, TITLE 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: Judy A. Griego, Director P.O. Box A Greeley, CO 80632 (970) 352-1551 18. Litigation For Contractor: +`• Contractor shall promptly notify the Departme n the eve that Contractor learns of any actual litigation in which it is a party defendant in a se t involves services provided under this Agreement. Contractor, within five (5) calendar days after b s ed with a summons, complaint, or other pleading which has been filed in any Federal or S court administrative agency, shall deliver copies of such document(s) to the Director of Hu ITI�x r he term "litigation" includes an assignment for the benefit of creditors, and filings gf e : ptcy, eorganization and/or foreclosure. 19. Termination This Agreement may individuals identified i obligation on appropriated i Therefore, the De¢ 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. ed at any time by either party giving thirty (30) days written notice to the ph 18. No portion of this Agreement shall be deemed to create an e County of Weld, State of Colorado, to expend funds not otherwise eeding year, as this Agreement is subject to the availability of funding. nt may terminate this Agreement at any time if the source of funding for the 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 9 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 go rning bodies shall have any pecuniary interest, direct or indirect, in the approved Agreement or the procds thereof. The Appearance of Conflict of Interest applies to the relationship of a Contracto?yvith the Department when the Contractor also maintains a relationship with a third pa y d the o relationships are in opposition. In order to create the appearance of a conflict of inter i t necessar for the Contractor to gain from knowledge of these opposing interes t necessary that the Contractor know that the two relationships are in opposition. Duri a of the Agreement, Contractor shall not enter into any third party relationship that gives th appea.:n`c"''¢¢¢¢¢¢ of creating a conflict of interest. Upon learning of an existing appearance of a conflict o ere ₹situation, Contractor shall submit to the Department, a full disclosure statement settin rth the • e ails that create the appearance of a conflict of interest. Failure to promptly submit a disc ur tatement required by this paragraph shall constitute grounds for the Department's termination, for a se,4its Agreement with the Contractor. Contractor certifies that Federal ap oTp 'a ds have not been paid or will be paid, by or on behalf of Contractor, to any person for infl n or a. empting to influence an officer or employee of an agency, a Member of Congress, an offic r loyee of Congress, or an employee of a Member of Congress in connection with the away ' o n e eral contract, the making of any Federal grant, the making of any Federal loan, the entering y cooperative agreement, and the extension, continuation, renewal, amendment, or modif i i n Federal contract, loan, grant, or cooperative agreement. 24. Stora ity and Retention of Records Contractor agree r. 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. 10 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 written confidentiality agreement and shall provide a copy of such agreement to the Department, if quested. 26. Proprietary Information Proprietary information for the purposes of this Agreement is info ating to a party's research, development, trade secrets, business affairs, internal operate nagement procedures and those of its customers, clients or affiliates, but does not includ on (1) lawfully obtained from third parties, (2) that which is in the public domain, or (3) th whit veloped independently. Neither party shall use or disclose directly or indirectly without or ten authorization any proprietary information concerning the other party obtain s a resu o this Agreement. Any proprietary information removed from the Department' to the Contractor in the course of providing services under this Agreement will be accorded at least sa e precautions as are employed by the Contractor for similar information in the course of ,own bu ess. 27. Independence of Contra "1 ,t .t an`Employee of Weld County Contract Professional agr tha 'eta' independent Contract Professional and that Contract Professional's officers, age pfoyees will not become employees of County, nor entitled to any employee benefits fr n s a result of the execution of this Agreement. Contract Professional shall perform its dutie, er an independent Contract Professional. Contract Professional shall be solely respons o is cts and those of its agents and employees for all acts performed pursuant to this Agreemen •+•tr: t Professional, its employees and agents are not entitled to unemployment insurance or work 't ompensation benefits through County and County shall not pay for or otherwise provide such coverage for Contract Professional or any of its agents or employees. Unemployment insurance benefits will be available to Contract Professional and its employees and agents only if such coverage is made available by Contract Professional or a third party. Contract Professional shall pay when due all applicable employment taxes and income taxes and local head taxes (if applicable) incurred pursuant to this Agreement. Contract Professional shall not have authorization, express or implied, to bind County to any agreement, liability or understanding, except as expressly set forth in this Agreement. Contract Professional 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 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 11. 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,nd D. 31. Acceptance of Services Not a Waiver Upon completion of the work, the Contractor shall submit to Dep rt nt on finals of all tests and results, reports, etc., generated during completion of this work. Acceptant p rtment of reports and incidental material(s) furnished under this Agreement shall n y relieve the Contractor of responsibility for the quality and accuracy of the service „int shall any action by the Department hereunder constitute or be construed to be a waiver b he De.. rtihent of any breach of covenant or default which may then exist on the part of the Contrac a he Department's action or inaction when any such breach or default shall exist shall not i Oair or pre dice any right or remedy available to the Department with respect to such breach or d au /and no assent, expressed or implied, to any breach of any one or more covenants, provisions or con ns Oche Agreement shall be deemed or taken to be a waiver of any other breach. Acceptance the Dep rtment of, or payment for, any services performed under this Agreement shall not be stu y waiver of any of the Department's rights under this Agreement or under the law gen 32. Employee Financial_ me s C&iflict of Interest. C.R.S. §§24-18-201 et seq. and §24-50-507 The signatories to thit aver that to their knowledge, no employee of Weld County has any personal or bene ' ial i, s hatsoever in the service or property which is the subject matter of this Agreement. T Co r has no interest and shall not acquire any interest direct or indirect, which would in any ner egree with the performance of the Contractor's services and the Contractor, shall not employ erson 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 conflict 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 Contract Professional'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. 12 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, Contract Professional agrees that the Weld County District Court shall have exclusive jurisdiction to resolve said dispute. 35. Subcontractors Contract Professional acknowledges that County has entered into this Agreement in reliance upon the particular reputation and expertise of Contract Professional. Contract Professional shall not enter into any subcontractor agreements for the completion of this project without County's prior written consent, which may be withheld in County's sole discretion. 36. Attorneys Fees/Legal Costs In the event of a dispute between County and Contract Professional concerninW his Agreement, the parties agree that each party shall be responsible for the payme ,otjtornexfees and/or legal costs incurred by or on its own behalf. 37. Ownership All work and information obtained by Contract Professi I u cr this Agreement or individual work order shall become or remain (as applicable), the pr $rty of Co ty. In addition, all reports, documents, data, plans, drawings, records and computer fi erated by Contract Professional in relation to this Agreement and all reports, test results and of tangible materials obtained and/or produced in connection with the performance of thi reeme whether or not such materials are in completed form, shall at all times be considered the . . - t County. Contract Professional shall not make use of such material for purposes other tha . .* nect on with this Agreement without prior written approval of County. 38. Interruptions Neither party otherwise to p its reasonable Governmental act 39. Severability t shall be liable to the other for delays in delivery or failure to deliver or obligation under this Agreement, where such failure is due to any cause beyond ncluding but not limited to Acts of God, fires, strikes, war, flood, earthquakes or 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. 13 IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first above written. ATTEST: BOARD OF COUNTY COMMISSIONERS Weld County Clerk to the Board WELD COUNTY, COLORADO BY: Deputy Clerk to the Board , Chair APPROVED AS TO FUNDING: APPROVED AS TO SUBSTANCE: Controller Elected Official or Department Head APPROVED AS TO FORM: County Attorney Director of General Se 14 EXHIBIT A WELD COUNTY'S REQUEST FOR PROPOSAL THIS PAGE INTENTIONA t1' T BLANK EXHIBIT B CONTRACTOR'S PROPOSAL 4. \se THIS PAGE INTENTIONA a° T BLANK EXHIBIT C SCOPE OF SERVICES alik 47e4\141 THIS PAGE INTENTIONA t T BLANK EXHIBIT D PAYMENT SCHEDULE THIS PAGE INTENTIONA T BLANK . P 5 EXHBIT B CONTRACTOR'S PROPOSAL Drug Testing Monday, June 13, 2016 DRUG & ALCOHOL TESTING! 721 4th St, Fort Lupton, CO 80621 (P) 303.502.3241 (F) 303.502.3267 Contents 1. INTRODUCTION 1.2 QUALIFICATIONS 1.3 MISSION 2.1 POLICY & PROCEDURE 2.2 CLIENT PROCESS 2.2 Done On Time's Procedure 3. PRICING 4. INSURANCE 1. INTRODUCTION Since 2008, Done On Time has been successfully drug and alcohol testing in the Oilfield and Pipeline industry throughout the northeastern counties of Colorado. This family business was started by a Daughter (Trish Lujan) and Mother (Bernice Roth) to fill a need in the Oil and Gas industry in the Brighton and Fort Lupton area. Quality of service and accurate results allowed this small family business to continue to grow. Done On Time started out as a mobile business to meet our clients needs of flexibility and convenience of providing our services on site as needed. After years on the road and to allow our organization to grow and flourish the business now has a home in Fort Lupton, Colorado. The office allows Done On Time to provide a clean and efficient environment for our clients that don't have the need to conduct testing on site but continues to support the mobile clients as needed. We also allow flexibility in our hours upon request from our clients. We pride ourselves on the quality of work which has allowed our company to grow to where we are today. Done On Time's goal is to continue to the level of service to all industries in the northeastern region of Colorado. 1.2 QUALIFICATIONS Done on Time hold certifications in alcohol, drug, hair, and swab/saliva testing from Kristina Consulting Group (KCG) Drug Alcohol Solutions. We continue to further our training in testing to meet the needs of all of our customers requests and demands. The owner Trish Lujan, holds a Degree in Behavioral Science from Metro State University and is working on Certified Addiction Counselor (CAC) I, II, II classes. 1.3 MISSION Provide anyone with the need of a drug or alcohol testing with reliable, quick and easy testing while treating every client with the dignity and respect every human being deserves. 2.1 POLICY & PROCEDURE The following sections will describe the client process (providing the sample) and Done On Time's procedure of processing the sample. 2.2 CLIENT PROCESS n Arrival Identity Verification 1"t Security Sanitize n Sample Lei Collect Sample Sanitize Receipt I Departure 1. Arrival - Upon arrival all clients will be greeted by the welcome staff to go over the testing process in detail 2. Identity Verification - All clients must have a photo ID or a picture in the Sentry system in order to verify a positive identification 3. Security - Clients belongings are removed from their pockets, searched, and items are secured in a separate location from the sampling and processing 4. Sanitize - Staff and Clients will wash their hands 5. Sample - Clients will be given a male/female bag kit, a staff monitor of the same sex in order for the sample to be given 6. Collect Sample - Samples will be kept in the client's possession (only females will transfer from the larger cup to the single container) until it is sealed with a <spell out acronym> (CCF) strip that contains; the date, and client's initials. The Client will place the sample provided into the collection bag and watch the collector seal the bag. 7. Sanitize - Staff and Clients will wash their hands 8. Receipt - A receipt with the CCF identification number and date of test will be given to the Client 9. Departure - The Client can collect their belongings and have completed their testing 2.2 DONE ON TIME'S PROCESS rut Process - Collected. Sampler Shipment'Q rn Monitors u Closei 1. Collect Sample - Samples will be kept in the client's possession (only females will transfer from the larger cup to the single container) until it is sealed with a <spell out acronym> (CCF) strip that contains; the date, and client's initials. The Client will place the sample provided into the collection bag and watch the collector seal the bag. 2. Shipment - The Client's sealed collection bag is then placed into a FedEx Clinical Pak, which is sent out daily at 3pm to guarantee results by the following business day 3. Monitor - Done On Time will monitor their internal system or Sentry to verify the results have been entered into the designated system. If additional follow-up is needed regarding results or delivery Done On Time will contact directly as needed. 4. Close - After the results have been recorded to the designated system the transaction is closed. 3. PRICING Below are the prices for our current testing types based on lab facility pricing but these prices are subject to change as facility rates change. Before pricing adjustments are made at Done On Time, a 30 day notice will be provided to our Clients. Test; Type Price 8 Panel UA $15.00 Breathalyzer $5.00 Hair * $125.00 Oral Swab * $45.00 * If a kit and form are provided by a testing facility, additional discounts may apply 4. INSURANCE Below is Done On Time's insurance verification. ACORROe CERTIFICATE OF LIABILITY INSURANCE oats NNCantlYI 06/13/2016 THIS CERTIFICATE 15 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: II the certificate holder Is an ADDITIONAL INSURED, Me policy(es) must have ADDITIONAL INSURED provision, or be endorsed. II SUBROGATION IS WAIVED, alibied to the tams and conditions of the policy, certain policies may require en endorsement A statement on this certificate does not confer rifts to the certificate holder In lieu of such endorsement(s). gceAGER stateFami •HIRAM LICEI STATE FARM AGENT 3600 MORRISON RD DENVER CO 60219 cT WL° AJOSE REYES Nu W"t _ 303-2354475 ISA.In 303-93&7512 � y JOSE®AGENTIJCEACOM RUPERT) AFFORDING CGRElAaI mac • Damn: Slate Farm Fire and Casualty Company 25143 main PATRICIA LUJAN 0BA DONE ON TIME 721 4Th ST STE E FORT LUPTON CO 80621 Mun, TAT MImFa ET DOURER D. mouse, M aF, COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY TEAT THE POLICES OF INSURANCE LISTED BELOW HAVE BEEN INDICATED NOT'.1mHSTANGING MIT REOLTREAIEF.T, TERM OR CONDITION OF ANY CERTIFICATE NAY BE ISSUED CR MAY PERTAIN. THE INSURANCE AFFORDED BY EXCLUSIONS AND CONDITIONS OF SUCHPPOUCIIES. LIMITS SHOWN MAY HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD CONTRACT OR OTHER DOCUMENT KITH RESPECT TO WHICH THIS THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. REDUCED BY PAID CLAIMS. Lq Imo/ int 0l K9.ELYCE 444,4 YM11I 'Guymo = DGY OP onare vin POusy FAA MbPOITYfn, LENTSXIce I 0.LGO. LLIABRItY El nfl B6CB-K067-0 05/24/2015 07/15/2017 rACHocgmREHCE 11.000,000 11 i CAILIms0E FIna Es eaa, r reel I TITDFID Ws on Term) 15.000 J Past, s.wmamy I I 4RRnPE1 GENERMAGGRECATE i 2,000.000 �M.[(nKoINA{TELazI i �. P0_CT. K' ■ tCC PRGLCTE- CDHPXPAGO I I I GTrem 1 unman yMyIT IItatwil I��IIi AIN AEG �,�I AUIOSOAY I •I I +`'O AJ:650.Y I_ I I I AUTOS M'A : ANOaatY S IRTEE0 EWGIE LAM s PNLY NAM FAR MGR, I sooty tr m Mix ARUM Is PrvawmewGARAGE I UYW01A W, 1 cam men WS CVa5AufE Hp.O?LRREME I AGGREGATE I I I ocal I RTTPHrpI I • msaccascounasaneN elm DIPnIEES WELTY qyt .. 'I�k,1m nRHI LAT.' ORR GA CAETATIMG Y. ,L AA I V:ante I I €RH EL FACH* oePeT e EL [TSETSE- EAELROYEE S RATA EL DS£ASE- POLICY WAY I 1 TWINATARI dPC/ANATIOR NDCJDDREIYD>lls MEOW am. YIDVW Mob MAYS, wits =ached a iron /goa Is FARRAR CANCELLATION WELD COUNTY HUMAN RESOURCES SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE THE EEPIRATION DATE THEREOF, NOME Wel BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS .umomn AuaTAINT / J ACORD 25 (201610JI 1088.2015 C ON. All rifts reserved. The ACORD name end logo apeilstereal merles of ACO TEI.N WIND l2 03-11.40111 TRISH LUJAN 100 Miller Ave 4205 I Brighton, CO So6or j 303-669-8507 I trishluionia@gmail corn SKILLS PROFILE - Excellent verbal and written communication skills Ability to follow instructions and complete tasks in a professional and timely manner independently - Excellent interpersonal communication skills, and the ability to handle stress. - Positive attitude with the willingness for flexibility and change. - Excellent leadership and time management skills - Familiar with OSHA, HIPAA, Medical Asepsis - Experienced working with Microsoft Office (Word, Excel, Outlook) Certifications o Cardiopulmonary Resuscitation (CPR) o First Aid o Certified Nursing Assistant (CNA) o Medication Administration Person (QMAP) EMPLOYMENT HISTORY Done on Time LLC Fort Lupton, CO - Certified drug and alcohol collector 6/1/2008 — Current Test Clients Accurately, Accounting, Court Reporting, Testifying in Court, and Case management Knowledge of laws and codes. drug test clients for court, DOT, and Non DOT, accounting, monitoring clients - Maintain tests supplies - Log Urinalysis (UA) results into company system - Ensure the UAs are logged and sent off in a timely manner Communicate with referral agencies of results Randomly schedule and oversee program UAs Submit reports and documentation before the Court and District Attorney or referring agencies Maintains current and accurate records and probation notes as established by department policy Inglenook at Brighton 2/1/2013 — 3/20/2015 Brighton, CO One on one caregiver Provide personal care assistance and adherence to a strict daily schedule consisting of daily hygiene care, incontinence care, meal preparation, medication administration, and Page 1 TRISH LUJAN loo Miller Ave rtzo5 I Brighton, CO 8o6ot 303-669-8507 I trishlulanio@gmail corn assistance with daily physical therapy. - Schedule home visits for physician assistants, home health care nurses, and weekly physical therapy sessions. Provide loving companionship with client, and maintain strong dialog with the family through excellent communication with Clients' family. Detailed record keeping regarding the health or physical changes or needs of my Client. EDUCATION Metropolitan State University of Denver o Bachelors in Behavioral Science, with an emphasis in Psychology Graduated 12/2013 Page 2 JOSE L HERNANDEZ JR 1581 Midland St Brighton, CO 80601 Cell 720-366-6302 jayhernandez2005rahotmail.com SUMMARY OF QUALIFICATIONS Six years Office Administrative and Clerical Support Handling confidential material Word Accounting software Microsoft Office Lotus Notes Presentations Planning Quick Books M2M Excellent phone and interpersonal skills EMPLOYMENT HISTORY Reliable Dependable Dedicated Attention to Detail Able to multitask Time management Typing 25wpm General Ledger Great organizational skills Career minded Accounts Payable Administrator- Leed Fabrication (promoted after 9 months from an assembler) April 2011 -May 2013 • Accounts Payable for over 100 vendors • Accurate record keeping • Accounts receivables making sure all vendor payments were made before due date • Scheduled and determined Accounts to be paid depending on amount, adjustments and credits • Tight schedule management and records for company meetings Office Manager — Mojo's Bar August 2009 -May 2011 • Liquor Purchasing • Scheduling shifts • Hiring and releasing employees • Light maintenance • Created dress code for all employees to keep our company presentable Office Manager, Nytis Exploration Inc. Denver, CO August 2007- August 2009 • Manage operation and maintenance of office equipment , maintain appropriate quantities of business supplies and maintain cost records and supply sources for all business supplies • Perform administrative tasks such as distributing the mail, scheduling meetings, order meals for board meetings JOSE L HEIiNAMYEi lY • Manage company bank accounts, deposit checks and reconcile monthly bank statements Facilities Clerk, TransMontaigne Inc. Denver, CO May 2005- August 2007 • Order office supplies, develop and maintain relationships with vendors as well as coordinate office equipment maintenance and repair • Sorting and delivering mail for an office with over two hundred employees • Provide backfill for reception desk as well as clerical projects on an as needed basis Driver, DHL Aurora, CO January 2000 -May 2005 • Receive daily packages from warehouse, load and unload van, deliver packages as well as pick packages from clients and return them to the DHL shipping facility Accounts Manager/Assistant Manager, Mr. Steve's Rent to Own Ft. Lupton, CO June 1996 -January 2000 • Handle daily store operations, create rental contracts, receive payments and maintain customer relations • Verify and submit to Corporate weekly employee payroll and daily deposits EDUCATION • P.SJ.A High School Graduate • Aims Community College 2 years REFERENCES • Harold Logan • Judy Kinard • Suzie Costly • Randy Joos Basic Materials- 720.407.7017 TransMontaigne Inc- 303.860.8200 Poison Spider Oil- 720.407.7015 Sun Office Products -303.229.8250 EXHIBIT C SCOPE OF SERVICES 1. Contractor will provide timely and quality random monitored sobriety services to clients referred by the Department. 2. Services will be available at 7214th Street, Fort Lupton, Colorado, 80621. 3. Contractor will have a qualified monitored sobriety collector on site Monday thru Friday, 10 a.m. to 7 p.m., with after hour appointments available if made by 4 p.m. Saturday and Sunday hours are available by appointment only. 4. Contractor will manage a random monitored sobriety line. The number line is accessible by phone at (303) 502-3241. Contractor will assign clients a unique number upon receipt of a referral. Clients will be required to call in seven (7) days a week. 5. Contractor will only provide services to referred clients who provide picture identification. A caseworker may provide a client photograph in lieu of formal picture identification if such identification cannot be provided. 6. Contractor will ensure best practices are followed for specimen collection, including observation of male and female clients by same gender staff. Contractor will have both male and female staff available during all business hours, and gender specific staff available as needed for appointments. 7. Contractor will not allow clients to make up missed monitoring unless prior approval from the Department is obtained. Either the caseworker or caseworker's supervisor may provide such approval. 8. Contractor will confirm any positive, negative or missed monitored sobriety within 24 hours through a phone call, test result, e-mail and/or fax to the Department (referring caseworker). 9. Contractor will confirm any non -negative specimen with gas chromatography/mass spectrometry (GC/MS). 10. Contractor will provide a recap of each referred client's prior months monitoring by the 7`h of the month following the month of service. 11. Contractor will submit the required monthly billing forms by the 7th of the month following the month of service. 12. Urinalysis results will be available online 24 hours per day, seven (7) days per week through the Norchem Sentry website (https://sentry.norchemlab.com). 13. Contractor understands that the Department will not reimburse Contractor for "no shows" or cancelled collections or appointments, either on the part of the client or the Contractor. 1 14. Contractor will make at least three (3) attempts to contact the client and set up services. The first attempt will occur within 24 hours of receiving the referral (excluding weekends and holidays). Contractor will document efforts to engage client in referred services. If after three (3) attempts the client does not respond the Contractor will notify the caseworker and the Child Welfare Contract and Services Coordinator immediately. 2 EXHIBIT D PAYMENT 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 specified 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 in Trails after May 31, 2017. 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 $15.00/Episode (8 Panel Urinalysis - Includes Ethyl Glucuronide - EtG) $5.00/Episode (Breathalyzer) $125.00/Episode (Hair Test) $45.00/Episode (Oral Swab) Contractor may not attempt to collect co -pays and/or fees for services for which a Department client is responsible, but which a particular client refuses or fails to pay. Contractor will collect any applicable sliding scale co -pays and credit the Department for any payment received on the monthly billing. 3. Submittal of Vouchers Contractor shall prepare and submit monthly an itemized voucher, and signed monthly report if applicable, certifying that services authorized were provided on the date(s) indicated and the charges made were pursuant to the terms and conditions of Paragraph 3 and Exhibit A. Contractor shall submit all monthly billings and applicable reports to the Department by the 7th day of the month following the month the cost was incurred. Failure to submit by the aforementioned deadline may result in forfeiture of payment. a. 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. b. For one-time services, proof of services rendered shall be receipt of the completed product. 1 c. For Monitored Sobriety services, proof of services rendered shall be the test result. A� d CERTIFICATE OF LIABILITY INSURANCE 1 °":; r 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 TEE 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 teetilcats holder Is an ADDITIONAL INSURED, the pollcy(Ms) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WANED, subject to the tams and conditions of the policy, certain policies may require an endorsement A statement on Ibis certificate don not confn dghb to the certificate holder In lieu of such endorsement(s). PROCUCER StateFarm HIRAM LICEA STATE FARM AGENT a�Co' 3800 MORRISON RD DENVER CO 80219 °Dina" JOSE REYES JUNI; � eat 303-935-7478 I _40X 703.9357512 AWaar . JOSE IAGENTLICFACOM INSU!®yUAFFORDING COyERIRE MACI Nan, A; Slate Farm Fire and Casually Company 25143 Race PATRICIA LUJAN PISA DONE ON TIME 721 4TH ST STE E ___ FORT LUPTON CO 80621 INSURERS: i reuusYte: lNwneen: MtuAua: MSWERF: • ...N. sawn InG,WGn. THIS IS TO CERTIFY THAT THE POLICIES OF NSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NGTIMTHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO %HICK THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS ANC CONDITIONS OF SUCH POLICIES. UNITS SHONE/ MAY HAVE BEEN REDUCED SY PAID CLAIMS. 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Calomdo 80831 H SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATMN DATE THEREOF. NOTICE VatL BE DE NERED IN ACCCRDANCF WITH DM POLICY PROVISIONS. A l ACORO 25 (201013) O19D8.201S ACORD CORPORATION. All Hghts'rssernO. The ACORD name and logo are reglatered marks of ACORD MIAs 132010.13 01162O16 Hello