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Home My WebLink About20162040.tiff0 50 CONTRACT AGREEMENT AMENDMENT BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND ALTERNATIVE HOMES FOR YOUTH, INC. (Core) This Agreement Amendment, made and entered into 0.11 r) 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 Alternative Homes for Youth, Inc., hereinafter referred to as the "Contractor". WHEREAS the parties entered into an Agreement for Community Transition Services and Mental Health Services (the "Original Agreement") identified by the Weld County Clerk to the Board of County Commissioners as document No. 2014-2476, approved on August 11, 2014. WHEREAS the parties hereby agree to amend the term of the Original Agreement in accordance with the terms of the Original Agreement, which is incorporated by reference herein, as well as the terms provided herein. NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows: • The Original Agreement ended on May 31, 2015. • The Original Agreement was amended for an additional term of June 1, 2015 -May 31, 2016. This Agreement Amendment is identified by the Weld County Clerk to the Board of County Commissioners as document No. 2015-1848(2), approved on June 24, 2015. • The Amendment(s), together with the Original Agreement, constitutes the entire understanding between the parties. The following change is hereby made to the Contract Documents: 1. Term This agreement shall become effective on June 1, 2014, upon proper execution of this Agreement and shall expire May 31, 2017, unless sooner terminated as provided herein. 2. None • All other terms and conditions of the Original Agreement remain unchanged. e2: atto4a- /AD a2 7 2016-2040 a b orl IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first above written. COUNTY: ATTEST: `G�,dtdov � •�o%�k Weld • n y Clerk to the Boa d By: Deputy Clerk to the Bo BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO Mike Freeman, Chair JUN 2 Z ZO'b CONTRACTOR: Alternative Homes for Youth, Inc. 1110 M Street Greeley, Colorado 80631 (970) 353-6 By: Sh.y filler, Executive Director Date: tP —6—f 020/! -0,70 �o ALTEHOM-02 CWATSON AWRE CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DO/YYYY) 10/23/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER TrueNorth PO Box 847 Longmont, CO 80502 INSURED Alternative Homes for Youth, Inc 1110 M Street Greeley, CO 80631 CONTACT NAME: Christi Nistler PHONE Exll: (303) 776-5122 I ra/c, No): (303) 776-5495 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A Underwriters at Lloyds 15792 INSURER B : Great American Insurance Company of New York 22136 INSURER C:Pinnacol Assurance Company 41190 INsuRERO:Philadelphia Indemnity Insurance Company 18058 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: • THIS INDICATED. CERTIFICATE EXCLUSIONS INSR LTR IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE ADDL INSD SUER WVD POLICY NUMBER POLICY EFF (MMIDD/YYYY) POLICY EXP (MMIDDIYYYY) LIMITS A X GE X _ COMMERCIAL GENERAL 1 X1 CLAIMS -MADE t_.. LIABILITY I OCCUR CJ10012715 10/01/2015 10/01/2016 EACH OCCURRENCE $ 1,000,000 DAMAGE TO KEAI ED PREMISES jEaoccurrence) $ 100,000 MED EXP (My one person) $ 1,000 1,000,000 3,000,000 PERSONAL 8 ADV INJURY GENERAL AGGREGATE $ $ $ 'L AGGREGATE LIMIT APPLIES POLICY I I ECT OTHER: PER: LOC PRODUCTS - COMP/OP AGG 3,000,000 $ B AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS _ X SCHEDULED CAP8639621 10/01/2015 10/01/2016 (Ea COMBINEDSINGLE LIMIT $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY(Per accident $ ) PROPERTY DAMAGE jer accident) $ $ UMBRELLA LIAR I EXCESS LIAB DED RETENTION O OCCUR CLAIMS -MADE' EACH OCCURRENCE $ AGGREGATE $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N N IA 1453282 07/01/2015 07/01/2016 X I STATUTE .I 10TH E.L. EACH ACCIDENT $ 100,000 E.L. DISEASE - EA EMPLOYEE $ 100,000 E.L. DISEASE - POLICY LIMIT $ 500,000 D A Cyber Liability Professional Liab PHSD1063810 CJ10012715 08/01/2015 10/01/2015 08/01/2016 10/01/2016 Per Occurrence Per Occurrence 1,000,000 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space Is required) Certificate holder is an Additional Insured regarding General Liability per form CJ111, when required by contract. CERTIFICATE HOLDER CANCELL Weld County Dept. of Social Services P O Box A Greeley, CO 80632 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 640t 1440/6 ACORD 25 (2014/01) © 1988-2014 ACORD CORPORATION. All rights reserved. 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