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CONTRACT AGREEMENT AMENDMENT BETWEEN
THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES
AND UABACO, LLC (Non -Core)
This Agreement Amendment, made and entered into 02:72,FJP
day of 2016by and
between the Board of Weld County Commissioners, on behalf of the Wel County Department of
Human Services, hereinafter referred to as the "Department", and UABACO, LLC, hereinafter referred
to as the "Contractor".
WHEREAS the parties entered into an Agreement for Monitored Sobriety Services, (the "Original
Agreement") identified by the Weld County Clerk to the Board of County Commissioners as document
No. 2014-3046, approved on October 6, 2014.
WHEREAS the parties hereby agree to amend the term of the Original Agreement in
accordance with the terms of the Original Agreement, which is incorporated by reference herein, as
well as the terms provided herein.
NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as
follows:
• The Original Agreement ended on May 31, 2015.
• The Original Agreement was renewed for the term of June 1, 2015 -May 31, 2016. The
Agreement Amendment is identified by the Weld County Clerk to the Board of County
Commissioners as document No. 2015-1612(4), approved on June 1, 2015.
• The Amendment, together with the Original Agreement, constitutes the entire
understanding between the parties. The following &ange 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.
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IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month,
and year first above written.
COUNTY:
ATTEST:
Weld C
By:
d4T.44i
BOARD OF COUNTY COMMISSIONERS
ty Clerk to the Board WELD COUNTY, COLORADO
Deputy Cle
I o S,31„e
Mike Freeman, Chair
JUN 2 2 2016
CONTRACTOR;
UABACO, LLC
1907 Boise Avenue, #2
Loveland, Colorado 80538
(970) 556-2227
By:
—11:0—:lcV
Nich Lam, Owner
Date: S z3 ZCi,E,
CERTIFICATE OF LIABILITY INSURANCE
I DATE (MINDONYYY)
1T
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.HIS
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
certificate holder In lieu of such endorsement(s).
the terms and Conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the
PRODUCER
StateFarm
INSURED
COVERAGES
BOB SANDERSON
608 E. HARMONY ROAD 3201
FORT COLLINS, CO 80525
UABA CO LLC
C/O NICH LAM
1703 FALCON RIDGE DR
FORT COLLINS, CO 80528-5103
CERTIFICATE NUMBER:
CONTACt
NAME:
PHONE .970-223-7254
e. ExTJE_._
EMAIL
ADDRESS. .._.._
... INSURER(S) AFFORDING COVERAGE
INSURER A _State Farm FIre and Casually Company
INSURER 8 : —_..
INSURER C
INSURER O
INSURER E_
INSURER F :
FAX
c 97O-226-3195
REVISION NUMBER:
RAID.*
25143
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LIIS]tu BELOW HAVE THE POLICY
INDICATED. NOTWITHSTANDING ANY REQUIREMENT DEMENT TERM OR CONDITION F ANY CONUTRAC TO
OITHE-RREDOC ENT VVITHERESPECT TO WHICH THIRIGS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED
EXCLUSIONS AND CONDIT IONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAIDCLAIMSO HEREIN IS SUBJECT TO ALL THE TERMS,
LTR TYPE OF INSURANCE
AWL -SUER
IMO YYVD POLIO POLICY EFF POLICY EXP
I' tMMIO YYYYjj
Y NUMBER
I,Y1,
A X COMMERCIAL GENERAL LIABILm V 96 -BT -U327-5 04/0112016
CLAIMS-MAVt OCCUR
GFKL AGGREGATE LIMIT APPLIES PER
POLICY .. I JPEIeT I I LOC
09iER
AUTOMOBILE UABIIJRY
ANY AUTO
ALL OWNED
..._ AUTOS
HIRED AUTOS
UNITS
0410112017 ` EACH OCCURRENCE
' OAMAOF TO RCNTED
PREMISES {Ea or..,ugenoe)
I MED EXP Any one pesrr,i $
PERSONAL. & ADV INJURY
GENERAL AGGREGATE
PRODUCTS - CC* 0p
BUSINESS PROP
CEO 4BINED SINGLE LIMIT
(Ea straiont.I _
BODILY INJURY (Per prrannl S
BODILY INJURY IP,v �S
I
SCHEDULED
__ AUTOS
NON-ONMFD
, AUTOS
UMBRELLA L IAO
EXCESS L IAB
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__ OCCUR
CLMdS-MADE
A 'WORKERSCOMPENSATION
AND EMPLOYERS' UABlUTY
ANY DROPRItTORIPA4T>4E4i1XE-Cu Y 1 N
OFF>CER,MEMBE 4 tXCLUUE ). 'TIVF N I,N I A''.
1(Mandrtory In NH)
II yts, dyecnbs uno
or SCRIP I ION 01- OPERA I IONS below
DESCRIPTION OF OPERATIONS 7 LOCATIONS ( VEHICLES IACOR
DRUG TESTING I DATA COLLECTION
CERTIFICATE HOLDER
95 -B9 -H395-5 O3/3OI2O16
S
S
EACH OCCURRENCE
,AGGREGATE
0313012017 Sran
rIITr I ER
F L EACH ACCIDENT
C L DISEASE - EA EMPLO
E L DISEASE P
101, Additional Rmrlm Schauae, m
ay Nibo •t1►chod Y mom spacei4'e4uirad)
Y LIM
1.000, 000
300,000
5.000
2,000,000
2,000,000
21,2
500,000
WELD COUNTY
1160O ST
GREELEY, CO 80631
ACORD 25 (2014/01)
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WMLL BE DELIVERED W
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORREDREPR.Y
19:.-2t114LADORD CORPORATION- AU rights reserved.
The ACORD name and logo are registered ma ACORD
1OO1486 12849.9 O2 -O4 -24i4
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