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Home My WebLink About20162722.tiffMEMORANDUM DATE: May 23, 2016 TO: Board of County Commissioners — Pass -Around FR: Judy A. Griego, Director, Human Services RE: Weld County Department of Human Services' Child Welfare PY2016-17—Core and Non -Core Contracted Providers Please review and indicate if you would like a work session prior to placing this item on the Board's agenda. Request Board Approval of the Department's Child Welfare PY2016-17-Core and Non - Core Contracted Providers. The briefing document (attached) reflects the contractors that have been selected to provide services during the coming program year. Core and Non -Core (Child Welfare) contracts listed in document are effective June 1, 2016. The document reflects contractors who are renewing their original contract with new rates and/or services and new contractors awarded through the bid process. The Families, Youth and Children Commission reviewed and approved the contractors and rates on April 29, 2016. Please note, the Department is still in the process of negotiation with, or obtaining additional information from, a few additional contractors. Contractors not included on the attached document at this time will be sent through at a later date. Upon Board approval of the contractors listed on the Briefing Document, signed agreements or agreement addendums will be obtained from contractors and submitted through Contract Management System (CMS) for final Board approval. I do not recommend a Work Session. I recommend approval of Contracted Providers.. Approve Request BOCC Agenda Work Session Sean Conway Steve Moreno Barbara Kirkmeyer Mike Freeman Julie Cozad Pass -Around Memorandum; May 23, 20 No n CMS Fis j2 �P"age 1 the -64/7 CP afro\d- .I.0-4+ZoDQ CHILD PROTECTION AGREEMENT FOR SERVICES BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND ADOPTION OPTIONS (Non -Core) This Agreement, made and entered into th 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 Adoption Options, 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 accomplished from and with appropriate agencies; and WHEREAS, the Colorado Department of Human Services has provided Core Services funding to the Department for Relinquishment Counseling. NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows: 1. Term This agreement shall become effective on June 1, 2016, upon proper execution of this Agreement and shall expire May 31, 2017, unless sooner terminated as provided herein. The agreement is for a period of three years. However, the agreement must be renewed by both parties, in writing, on an annual basis. 2. Scope of Services Services shall be provided by the Contractor to any person(s) eligible for services in compliance with Exhibit B, Contractor's Proposal and Exhibit C, Scope of Services. 3. Referrals, Billing and Tracking a. Contractor understands and will comply with all aspects of the referral authorization, billing and tracking requirements as set forth by the Department. Failure to comply with all aspects may result in a forfeiture of payment. 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. Ocwza,i 4,04ac4.. 22-aesi( 1 2016-2722 �oo06i 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 private insurance and/or other funding sources such as Medicaid (if Contractor is a Medicaid eligible provider) or Victim's Compensation must be exhausted before Core Services or other Department funds can be accessed for services. b. Payment shall be made in accordance with Exhibit A, Weld County's Request for Proposal, Exhibit B, Contractor's Proposal, Exhibit C, Scope of Services, and Exhibit D, Payment Schedule, attached hereto and incorporated herein by reference, so long as services are rendered satisfactorily and in accordance with the Agreement. c. 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. d. The Department may withhold reimbursement if Contractor has failed to comply with any part of the Agreement, including the Financial Management requirements, program objectives, contractual terms, or reporting requirements. In the event of forfeiture of reimbursement, Contractor may appeal such circumstance in writing to the Director of Human Services. The decision of the Director of Human Services shall be final. 5. Financial Management At all times from the effective date of the Agreement until completion of the Agreement, Contractor shall comply with the administrative 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 2000d-1 Title VI of the Civil Rights Act of 1964, 42 U.S.C. Sections 2000d-1 a seq. and its implementing regulation, 45 C.F.R. Part 80 et. seq.; and - all provisions of the Civil Rights Act of 1986 so that no person shall, on the grounds of race, creed, color, sex, or national origin, be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under the approved Agreement. - Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. Section 794, and its implementing regulations, 45 C.F.R. Part 84; and the Age Discrimination Act of 1975, 42 U.S.C. Section 6101 et. seq. and its implementation regulations, 45 C.F.R. Part 91; and - Title VII of the Civil Rights Act of 1964; and the Age Discrimination in Employment Act of 1967; and - the Equal Pay Act of 1963; and - the Education Amendments of 1972; and - Immigration 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.5.) 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 Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State or Local) transaction or contract under public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; and - are not presently indicted for or otherwise criminally or civilly charged by a government entity (federal, state or local) with commission of any of the offenses enumerated in this certification; and - have not, within a three-year period preceding this Agreement, had one or more public transactions (federal, state, or local) terminated for cause or default. e. Public Contracts for Services C.R.S. §8-17.5-101. Contract Professional certifies, warrants, and agrees that it does not knowingly employ or contract with an illegal alien who will perform work under this contract. Contract Professional 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). Contract Professional 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 Contract Professional that the subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this Agreement. Contract Professional 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 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. §8-17.5-102(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, 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. f. 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 outcomes in three areas; Safety, Permanency and Well Being of families. For each outcome, data and performance indicators measure each state's performance according to national standards and monitor progress over time. Following the review, a Program Improvement Plan (PIP) will be implemented for the state to enhance services to families. Contractor agrees to continually strive for positive outcomes in the areas of Safety, Permanency and Well Being. Contractor will ensure that any employee or subcontractor of Contractor providing services under this Agreement will work towards positive outcomes in the aforementioned three areas as outlined under the Child and Family Services Review (CFSR), and will address the aforementioned three areas when completing monthly reports as required by Paragraph 3(d) of this Agreement. 9. Insurance Requirements Contractor and Department agree that Weld County, the Board of County Commissioners of Weld County, its officers and employees, shall not be held liable for injuries or damages caused by any negligent acts or omissions of the Contractor, it subcontractor, or their employees, volunteers, or agents while performing duties described in this Agreement. Contractor shall indemnify, defend and hold harmless Weld County, the Board of County Commissioners of Weld County, its employees, volunteers and agents. Contractor shall provide 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 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. b. 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: 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. ii. 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. 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, 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. d. 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. 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. e. 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 as follows f. Waiver of Subrogation: For all coverages, Contractor/Contract Professional's insurer shall waive subrogation rights against County. g. 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. 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. 7 11. Training 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 of the performance of this Agreement shall be conducted by the Contractor and the Department. The results of the monitoring and evaluation shall be provided to the Board of Weld County Commissioners, the Department and the Contractor. Contractor shall permit the Department, and any other duly authorized agent or governmental agency, to monitor all activities conducted by the Contractor pursuant to the terms of this Agreement. As the monitoring agency may in its sole discretion deem necessary or appropriate, such program data, special analyses, on -site checking, formal audit examinations, or any other reasonable procedures. All such monitoring shall be performed in a manner that will not unduly interfere with the work conducted under this Agreement. 14. Modification of Agreement All modifications to this Agreement shall be in writing and signed by both parties. 15. Remedies The Director of Human Services or designee may exercise the following remedial actions should s/he find the Contractor substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by the Contractor. These 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 8 Department as a debt due to the Department or otherwise as provided by law. 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: For Contractor: Heather Walker, Administrator Adrienne Elliott, Executive Director 17. Notice 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: Adrienne Elliott, Executive Director 13900 East Harvard Avenue, Suite 200 Aurora, Colorado 80014 (303) 695-1601 Contractor shall promptly notify the Department in the event that Contractor learns of any actual litigation in which it is a party defendant in a case that involves services provided under this Agreement. Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading which has been filed in any Federal or State court or administrative agency, shall deliver copies of such document(s) to the Director of Human Services. The term "litigation" includes an assignment for the benefit of creditors, and filings of bankruptcy, reorganization and/or foreclosure. 19. Termination This Agreement may be terminated at any time by either party giving thirty (30) days written notice to the individuals identified in paragraph 18. No portion of this Agreement shall be deemed to create an obligation on the part of the County of Weld, State of Colorado, to expend funds not otherwise appropriated in each succeeding year, as this Agreement is subject to the availability of funding. Therefore, the Department may terminate this Agreement at any time if the source of funding for the 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. 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 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 governing bodies shall have any pecuniary interest, direct or indirect, in the approved Agreement or the proceeds thereof. The Appearance of Conflict of Interest applies to the relationship of a Contractor with the Department when the Contractor also maintains a relationship with a third party and the two relationships are in opposition. In order to create the appearance of a conflict of interest, it is not necessary for the Contractor to gain from knowledge of these opposing interests. It is only necessary that the Contractor know that the two relationships are in opposition. During the term of the Agreement, Contractor shall not enter into any third party relationship that gives the appearance of creating a conflict of interest. Upon learning of an existing appearance of a conflict of interest situation, Contractor shall submit to the Department, a full disclosure statement setting forth the details that create the appearance of a conflict of interest. Failure to promptly submit a disclosure statement required by this paragraph shall constitute grounds for the Department's termination, for cause, of its Agreement with the Contractor. Contractor certifies that Federal appropriated funds have not been paid or will be paid, by or on behalf of Contractor, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of an Federal contract, loan, grant, or cooperative agreement. 24. Storage, Availability and Retention of Records Contractor agrees that 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, 10 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. 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 a written confidentiality agreement and shall provide a copy of such agreement to the Department, if requested. 26. Proprietary Information Proprietary information for the purposes of this Agreement is information relating to a party's research, development, trade secrets, business affairs, internal operations and management procedures and those of its customers, clients or affiliates, but does not include information (1) lawfully obtained from third parties, (2) that which is in the public domain, or (3) that which is developed independently. Neither party shall use or disclose directly or indirectly without prior written authorization any proprietary information concerning the other party obtained as a result of this Agreement. Any proprietary information removed from the Department's site by the Contractor in the course of providing services under this Agreement will be accorded at least the same precautions as are employed by the Contractor for similar information in the course of its own business. 27. Independence of Contractor: Not an Employee of Weld County Contract Professional agrees that it is an independent Contract Professional and that Contract Professional's officers, agents or employees will not become employees of County, nor entitled to any employee benefits from County as a result of the execution of this Agreement. Contract Professional shall perform its duties hereunder as an independent Contract Professional. Contract Professional shall be solely responsible for its acts and those of its agents and employees for all acts performed pursuant to this Agreement. Contract Professional, its employees and agents are not entitled to unemployment insurance or workers' compensation 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 A provide proof thereof when requested to do so by County. 11 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 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, and D. 31. Acceptance of Services Not a Waiver Upon completion of the work, the Contractor shall submit to Department originals of all tests and results, reports, etc., generated during completion of this work. Acceptance by Department of reports and incidental material(s) furnished under this Agreement shall not in any way relieve the Contractor of responsibility for the quality and accuracy of the services. In no event shall any action by the Department hereunder constitute or be construed to be a waiver by the Department of any breach of covenant or default which may then exist on the part of the Contractor, and the Department's action or inaction when any such breach or default shall exist shall not impair or prejudice any right or remedy available to the Department with respect to such breach or default; and no assent, expressed or implied, to any breach of any one or more covenants, provisions or conditions of the Agreement shall be deemed or taken to be a waiver of any other breach. Acceptance by the Department of, or payment for, any services performed under this Agreement shall not be construed as a waiver of any of the Department's rights under this Agreement or under the law generally. 32. Employee Financial Interest/Conflict of Interest. C.R.S. §§24-18-201 et seq. and §24-50-507 The signatories to this Agreement aver that to their knowledge, no employee of Weld County has any personal or beneficial interest whatsoever in the service or property which is the subject matter of this Agreement. The Contractor has no interest and shall not acquire any interest direct or indirect, which would in any manner or degree with the performance of the Contractor's services and the Contractor, shall not employ any person 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. 12 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. 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, concerning this Agreement, the parties agree that each party shall be responsible for the payment of attorney fees and/or legal costs incurred by or on its own behalf. 37. Ownership All work and information obtained by Contract Professional under this Agreement or individual work order shall become or remain (as applicable), the property of County. In addition, all reports, documents, data, plans, drawings, records and computer files generated by Contract Professional in relation to this Agreement and all reports, test results and all other tangible materials obtained and/or produced in connection with the performance of this Agreement, whether or not such materials are in completed form, shall at all times be considered the property of the County. Contract Professional shall not make use of such material for purposes other than in connection with this Agreement without prior written approval of County. 38. Interruptions Neither party to this Agreement shall be liable to the other for delays in delivery or failure to deliver or otherwise to perform any obligation under this Agreement, where such failure is due to any cause beyond its reasonable control, including but not limited to Acts of God, fires, strikes, war, flood, earthquakes or Governmental actions. 39. Severability 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 oarties hereto haw: c .'v executed the AR•eemert a•. o& the day. •ronrh and year !;!-st above wr tten. COUNTY: ATTEST datAiltiV•:(/4 Weld Co..nty Clerk to the Board By Dec)h& -Clerk to the Board 14 BOARD OF COUNTY COMMISSIONERS WELD COUNTY. COLORADO Mike Freer''an, Chair AUG 2 2 2016 ONTRACTOR: Adoption Options 13900 East Harvard Avenue. S,.'te 200 Aurora. Colorado 80014 303) 695.16D By Date 4t1 Adrienne Elliott. Exec..t ve Director talk-a77da EXHIBIT A WELD COUNTY'S REQUEST FOR PROPOSAL Bid No.: B1600047 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 1-10 OF THIS REQUEST FOR PROPOSAL CONTAIN GENERAL INFORMATION. NOT ALL OF THE INFORMATION CONTAINED IN PAGES 1-10 MAY BE APPLICABLE. SPECIFICATIONS UNIQUE TO THIS REQUEST FOR PROPOSAL FOLLOW PAGE 11. I. 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: VARIOUS ENGLISH AND BILINGUAL (ENGLISH/SPANISH) SERVICES (AS DEFINED ON PAGES 15-17) 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 Various Services (as described on pages 15-17). 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 Bid No.: B1600047 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 Page 2 Bid No.: B1600047 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 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 Page 3 Bid No.: B1600047 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. 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 funds under 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, Page 4 Q. Bid No.: B1600047 State of Colorado. 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. 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 Page 5 Bid No.: 81600047 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 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 Page 6 Bid No.: B1600047 Agreement by County, and shall continue for three years. However, the agreement must be renewed by both parties, in writing, on an annual basis. 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.: B1600047 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 Page 8 Bid No.: B1600047 * A provision that coverage is non-contributory with other coverage or self- insurance provided by County. (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.: B1600047 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.: 81600047 Project Overview: The Weld County Department of Human Services (WCDHS) is seeking qualified English-speaking and bilingual (English/Spanish) providers in various service areas under various funding sources. Service areas include, but are not limited to, Anger Management/Domestic Violence, Day Treatment, Foster Parent Consultation, Foster Parent Training, Functional Family Therapy, Kinship Services (Therapeutic), Home Studies/Relinquishment Counseling, Life Skills, Mediation, Mental Health, Monitored Sobriety, Multi -Systemic Therapy, Home Based Intervention including 24/7 Crisis Intervention, Sexual Abuse Treatment, and Substance Abuse Treatment Services and Aftercare Services. Refer to pages 15-17 for specific definitions related to the above -mentioned service areas. Qualifications: To be considered, a bidder must meet the following minimum qualifications: 1) If submitting to provide bilingual services, a bidder must demonstrate language proficiency at Full Professional Proficiency or higher, as defined by the U.S. Department of State, and as noted below. • Full Professional Proficiency: Able to use and read the language fluently and accurately on all levels pertinent to professional needs • Native or Bilingual Proficiency: Equivalent to that of an educated native speaker (both speaking and reading). 2) Bidder must agree to language proficiency testing that may include assessment of reading, writing and comprehension of Spanish, as well as a face-to-face conversation with a known native or proficient Spanish speaker selected by Weld County. 3) 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. 4) 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. Each service must be submitted as its own proposal, inclusive of scope of services and rate information. Page 11. Bid No.: B1600047 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) A bidder must demonstrate the knowledge, training and expertise to conduct the proposed service(s). 7) A bidder must provide a current resume, as well as proof of licensure, for self, staff members and contractors of the bidder. Additionally, a bidder must include proof of inclusion on State vendor lists if applicable to the proposed service (ex. Home Study Providers, Sex Offender Management Board Providers). 8) 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. 9) A bidder must demonstrate familiarity with Trauma Informed Care. Bidder must provide copies of applicable training certificates, or proof of registration for training, for all staff members who manage and/or administer services under this proposal. 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. Page 12 Bid No.: B1600047 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) Identification of language(s) and proficiency level, if applying to provide bilingual (English/Spanish) services. 2) 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. 3) Sufficient information concerning each proposed service for Weld County to evaluate whether or not the bidder meets "minimum qualifications" for all bidders. Each service must be submitted as its own proposal, inclusive of scope of services and rate information. 4) 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. 5) 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. 6) 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. 7) 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. 8) 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). The rate schedule must demonstrate an exact fee for the described service (s). Approximate rates or a range of rates for a service will not be accepted. Page 13 Bid No.: B1600047 9) 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. 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 Bid No.: B1600047 SERVICE AREA DEFINITIONS (NOT LIMITED TO THIS LIST - OTHER SERVICES WILL BE CONSIDERED) Program;Area +r Mr" tk yk qy .. V' h}� )u'r.�I "y� �'R,__ R > .x''4 Definition 2 " ' * ° t , '_ S.I. w y�Op;, " r'a > 4 3, r�bi n �'"`N�$'c�ea + Y1 Aftercare Services Services provided to prepare a child for reunification with his/her family or other permanent placement and to prevent future out - of -home placement of the child. Anger Management/Domestic Violence Diagnostic and/or therapeutic services to assist in the development of the family services plan, to assess and/or improve family communication, functioning and relationships, and to prevent further domestic violence. Crisis Intervention and Stabilization Services Services that provide an immediate, in-person/in- home response to families, youth and children, in *crisis, 24 hours a day, seven (7) days a week. *A "crisis" is further defined as a situation or circumstance, usually acute (recent) in nature, which breaks down the normal functioning of an individual and/or family, and results in the inability of the individual and/or family to resolve the crisis through normal coping behaviors, or without immediate intervention. Day Treatment Comprehensive, highly structured services that provide education to children and therapy to children and their families. Foster Parent Consultation Services provided to foster and group home families caring for WCDSS children and youth in their homes to enhance and improve the quality of care being provided. Foster Parent Training Core training for new Weld County foster parents. Page 15 Bid No.: B1600047 'Program Area Definition Functional Family Therapy Intensive family -based treatment that addresses the pervasive patterns of relational dysfunction known to be determinants of conduct disorder, violent acting out, and substance abuse among youth 10-18 years old. Home -Based Intervention Services provided primarily in the home of the client that include a variety of services which can include therapeutic services, concrete services, collateral services and *crisis intervention directed to meet the needs of the child and family. *Crisis Intervention is defined as 24/7 phone access and in -home counseling. Kinship Services (Therapeutic) Kinship services in the areas of (1) consultation and kinship parent support specific to a child placed in a kinship home, (2) corrective consultation specific to a child placed in a kinship home, and (3) critical care consultation specific to a child placed in a kinship home. Children placed in kinship care are maintained in the lowest level of care and least restrictive setting when out -of -home placement is necessary. Life Skills Visitation (both in -home and in -office) and services provided primarily in the home that teach household management, effective access to community resources, parenting techniques and family conflict management. Page 16 Bid No.: 81600047 Program-Area]„i Definition`£ ; Mediation/Intensive Family Therapy Therapeutic intervention typically with all family members to improve family communication, functioning and relationships. Mental Health Services Diagnostic and/or therapeutic services to assist in the development of family services plan, to assess and/or improve family communication, functioning and relationships. Multisystemic Therapy Intensive family- and community -based treatment program designed to make positive changes in the various social systems (home, school, community, peer relations) that contribute to the serious antisocial behaviors of children and adolescents who are at risk for out -of -home placement. Relinquishment Counseling Relinquishment counseling for parents considering relinquishment of their children. Substance Abuse Treatment Services Diagnostic and/or therapeutic services to assist in the development of the Family Service Plan (FSP), to assess and/or improve family communication, functioning and relationships, and to prevent further abuse of drugs or alcohol. Page 17 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 accom 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 parts felt pvenant 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 ' ed herein. e agreement is for a period of three years. However, the agreement must be renewed b¢oiarties, in writing, on an annual basis. 2. Scope of Services Services shall be provided by the d..'rtor t any person(s) eligible for services in compliance with Exhibit B, Contractor's Proposa p . Sq bit C, Scope of Services. 3. Referrals Billin• a a. Contrac r uniferef�Stds and will comply with all aspects of the referral authorization, billing and tracking r sr a 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 7`h 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 eligible'ptpv 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. c. Payment pursuant to this Agreemen upon, the continuing availability of said fu d. The Department may with the Agreement, including the terms, or reporting requirehe�e appeal such circumstance in of Human Services sha 5. Financial an ty's Request for Proposal, Exhibit it D, Payment Schedule, attached s are rendered satisfactorily and in er in whole or in part, is subject to, and contingent e purposes hereof. ement if Contractor has failed to comply with any part of ial M 'nagement 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 :n Re' ective date of the Agreement until completion of the Agreement, Contractor shall comply with the r 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. and4 - ' ementing regulation, 45 C.F.R. Part 80 et. seq.; and - all provisions of the Civil Rights Act of 1986 so tha race, creed, color, sex, or national origin, be exc benefits of, or be otherwise subjected to d' - Section 504 of the Rehabilitation Act implementing regulations, 45 C.F.g$art 84; a erTin shall, on the grounds of participation in, be denied the under the approved Agreement. U.S.C. Section 794, and its - the Age Discrimination Act o75? U.S.C. Section 6101 et. seq. and its implementation regulatio - Title VII of the CfRJg{its Acr{of 1964; and - the Age criin Employment Act of 1967; and - thea Pact of 1963; and 4ation Amendments of 1972; and - tmnirgration 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, had a civil judgment rendered against them for commission of f connection with obtaining, attempting to obtain, or perform Local) transaction or contract under public transactions violation statutes or commission of embezzlement, theft, forger of records, making false statements, or receiving sto - are not presently indicted for or othe entity (federal, state or local) with commi certification; and nt, been convicted of or ud or criminal offense in ublic (Federal, State or deral or state antitrust falsification or destruction ;and ally or civilly charged by a government ytf the offenses enumerated in this - have not, within a three -ye d preceding this Agreement, had one or more public transactions (federal, state, or loc ter t$nated for cause or default. e. Public Contracts for Serv' R. §347.5-101. 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 Prac i I will confirm the employment eligibility of all employees who are newly hired for empl en r1 h United States to perform work under this Agreement, through participation in the E -V p gram or the State of Colorado program established pursuant to C.R.S. §8-17.5-102(5)(c a raprofessional 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 Contr t r onal that the subcontractor shall not knowingly employ or contract with an illegal alien to p r'k under this Agreement. Contract Professional shall not use E -Verify Program or State of Colo 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. §8-17.5-102(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. f. 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 rues in three areas; Safety, Permanency and Well Being of families. For each outcom d andB�erformance indicators measure each state's performance according to national standard 'tor progress over time. Following the review, a Program Improvement Plan (PIP) will !`1 rrtple„ented for the state to enhance services to families. Contractor agrees to continually strive for positive outc. i - ti he areas of Safety, Permanency and Well Being. Contractor will ensure that any employor subcontractor 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 required'�y_Paragr p 3(d) of this Agreement. 9. Insurance Requirements Contractor and Departme its officers and employees, omissions of the Con duties described i thi the Board of C eld County, the Board of County Commissioners of Weld County, be held liable for injuries or damages caused by any negligent acts or bcontractor, or their employees, volunteers, or agents while performing ent. Contractor shall indemnify, defend and hold harmless Weld County, issioners of Weld County, its employees, volunteers and agents. Contractor shall p 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 i�rnay deem necessary to cover its obligations and liabilities under this Agreement. b. Types of Insurance: Contractor/Contract Profe io shall��btain, and maintain at all times during the term of any Agreement, insurance in the to 'pfkinds and amounts: i. Workers' Compensation Insur s . cared by state statute, and Employer's Liability Insurance covering all of Con actor' o tract Professional's employees acting within the course and scope of their a plo nt. If Contractor is an Independent Contractor, as defined by the orado r er's Compensation Act, this requirement shall not apply. Contractor us bmit to the Department a Declaration of Independent Contractor Status Form prior h art of this agreement. ii. Commery a n dtbility Insurance written on ISO occurrence form CG 00 01 10/93 or ele}�> cov ring premises operations, fire damage, independent Contractors, u'' and completed operations, blanket contractual liability, personal injury, a2dv yi'iability 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/ContractProfes, 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 shallrovide a copy of this or broker provide proof of eserves the right to require f insurance, a policy, or other proof of his sole discretion. e. Additional Insureds: For gen "1 liability, ess/umbrella liability, pollution legal liability, liquor liability, and inland marine, C an additional insured as follows f. Waiver of Subro shall waive subrogation Zr/Contract Professional's insurer shall name County as a aon, Fdra J1?overages, Contractor/Contract Professional's insurer ains County. B. Subcont, for A{s 'contractors, subcontractors, independent contractors, sub - vendors, suppliers , - entities providing goods or services required by this Agreement shall be subject to th • quirements herein and shall procure and maintain the same coverages required f Co c o /Contract Professional. Contractor/Contract Professional shall include all such co a ors, independent contractors, sub -vendors suppliers or other entities as insureds unde oli s or shall ensure that all subcontractors maintain the required coverages. Contract 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 rformance of this Agreement shall be conducted by the Contractor and the Department. The res of the monitoring and evaluation shall be provided to the Board of Weld County Commibsioilgrs, the Department and the Contractor. Contractor shall permit the Department, and any other .. +:thti ized agent or governmental agency, to monitor all activities conducted by the Contractor pursrant to - eFerms of this Agreement. As the monitoring agency may in its sole discretion deem nece ppropriate, such program data, special analyses, on -site checking, formal audit examin ons, or a other reasonable procedures. All such monitoring shall be performed in a manner t t wvi tnot unduly interfere with the work conducted under this Agreement. 14. Modification of Agreemen) All modifications to this Agree r tt I be in writing and signed by both parties. 15. Remedies The Director ofH an'LT' ic- or designee may exercise the following remedial actions should s/he find the Contractor "Lbs a ti 4ly failed to satisfy the scope of work found in this Agreement. Substantial failure to satis s[ pe of work shall be defined to mean incorrect or improper activities or inaction by the Contractor. T 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 Contractor shall promptly notify the Departme litigation in which it is a party defendant in a Contractor, within five (5) calendar days after which has been filed in any Federal or S document(s) to the Director of Hu benefit of creditors, and filings of .Tj�,7,prptcy, 19. Termination For Contractor: that Contractor learns of any actual involves services provided under this Agreement. ed with a summons, complaint, or other pleading administrative agency, shall deliver copies of such he term "litigation" includes an assignment for the eorganization and/or foreclosure. This Agreement may b" it ed at any time by either party giving thirty (30) days written notice to the individuals identif d i ph 18. No portion of this Agreement shall be deemed to create an obligation on pa o he County of Weld, State of Colorado, to expend funds not otherwise appropriated i Gfss eeding year, as this Agreement is subject to the availability of funding. Therefore, the D ent may terminate this Agreement at any time if the source of funding for the 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. 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 proc ds thereof. The Appearance of Conflict of Interest applies to the relationship of a Contract ith the Department when the Contractor also maintains a relationship with a third pa y d the wo relationships are in opposition. In order to create the appearance of a conflict of inter t necessar for the Contractor to gain from knowledge of these opposing interest { necessary that the Contractor know that the two relationships are in opposition. Du( "' , of the Agreement, Contractor shall not enter into any third party relationship that gives th appea' n of creating a conflict of interest. Upon learning of an existing appearance of a conflict o V 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 dis ur tatement required by this paragraph shall constitute grounds for the Department's termination, for se4` its Agreement with the Contractor. Contractor certifies that Federal a Contractor, to any person for infl a Member of Congress, an offic connection with the awar Federal loan, the entering i amendment, or modif 24. Store Yids have not been paid or will be paid, by or on behalf of or attempting to influence an officer or employee of an agency, oyee of Congress, or an employee of a Member of Congress in eral contract, the making of any Federal grant, the making of any y cooperative agreement, and the extension, continuation, renewal, Federal contract, loan, grant, or cooperative agreement. itv and Retention of Records Contractor agree 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, ifquested. 26. Proprietary Information Proprietary information for the purposes of this Agreement is info tt outing to a party's research, development, trade secrets, business affairs, internal operate -a 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 which veloped independently. Neither party shall use or disclose directly or indirectly without pn ten authorization any proprietary information concerning the other party obtain s a resulCo"f this Agreement. Any proprietary information removed from the Department' to Qthe Contractor in the course of providing services under this Agreement will be accorded at least t sa e precautions as are employed by the Contractor for similar information in the course of it pwn bu i ess. 27. Independence of Contra ftpt,: ,f}(bt an mployee of Weld County Contract Professional agr s tha afiindependent Contract Professional and that Contract Professional's officers, agen p ogees will not become employees of County, nor entitled to any employee benefits fr 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' e o is cts and those of its agents and employees for all acts performed pursuant to this Agreemen •o tr t Professional, its employees and agents are not entitled to unemployment insurance or work 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 inals of all tests and results, reports, etc., generated during completion of this work. Acceptant at;;. rtment of reports and incidental material(s) furnished under this Agreement shall n n y relieve the Contractor of responsibility for the quality and accuracy of the services ant shall any action by the Department hereunder constitute or be construed to be a waiver b ) he Dej: rtthent of any breach of covenant or default which may then exist on the part of the Contract. a +l' he Department's action or inaction when any such breach or default shall exist shall not i pair or pre dice any right or remedy available to the Department with respect to such breach or d au nd no assent, expressed or implied, to any breach of any one or more covenants, provisions or con ns *he 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 .nst waiver of any of the Department's rights under this Agreement or under the law gen 32. Employee Financ flict of Interest. C.R.S. §§24-18-201 et seq. and §24-50-507 The signatories to thi t aver that to their knowledge, no employee of Weld County has any personal or bend' 'al i , hatsoever in the service or property which is the subject matter of this Agreement. T o r has no interest and shall not acquire any interest direct or indirect, which would in any r 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 concernin a.his Agreement, the parties agree that each party shall be responsible for the paymeno$torneK fees and/or legal costs incurred by or on its own behalf. 37. Ownership All work and information obtained by Contract Professi. t,. i; •r this Agreement or individual work order shall become or remain (as applicable), the pr lay of Coiity. In addition, all reports, documents, data, plans, drawings, records and computer fi a 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 • y t County. Contract Professional shall not make use of such material for purposes other the t • y nect on with this Agreement without prior written approval of County. 38. Interruptions Neither party to is A$ e t shall be liable to the other for delays in delivery or failure to deliver or otherwise to p or obligation under this Agreement, where such failure is due to any cause beyond its reasonable rol ncluding but not limited to Acts of God, fires, strikes, war, flood, earthquakes or Governmental ac 39. Severability 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: Director of General Sent County Attorney 14 EXHIBIT B CONTRACTOR'S PROPOSAL THIS PAGE INTENTIONA T BLANK PROVIDER INFORMATION FORM (Proposal Cover Sheet) Weld County Department of Human Services (Adarh-av1 Ooh'(pns AGENCY OR PRIVATE PRACTICE. (-tU�1f�Y1 nt lioT PRIMARY. CONTACT -FULL NAME. 1)3,109S: 1 tco PHONE NUMBER EXT. TRAILS PROVIDER ID HE Known) eutu ire ` i irr Jo r PRIMARY CONTACT - TITLE, 3o3 , 6qs loot FAXNUMBER Get iiatt@(,tit, hGnS,Con W'al. a4hati—tilG►-IS•fowl PRIMARY CONTACT EMAIL -ADDRESS AGENCY/PRACTICE WEB ADDRESS,IFAPPLICABLEi 390 b Iry Avec 51t2,00 AGENCY MAILING ADDRESS Lori v I.n REFFERAL CONTACT- FULL NAME DIFFERENTTHANDRIMARY CONTACT! ,303} (611 5:1(06( PEFERRACCONTACT PHONE NUMBER EXT. kunipit_ Fowl/ Assh i'i-c&ior 1 Plaumerri— gLienifectitv I jar Q a4h a-10AenS• REFERRAL C ACT ELMAILADORESS Ci7rr\. REFERRAL CONTACT - TITLE I certify that the services offered for intended use by Weld County will meet, all the specifications it has Aso indicated m this bid form. The Board of Weld County Commissioners reserves the right to reject any or all bids, to waiveany informality in the bids, and to accept the bid, or part of a bid, that, m the opinion of the Board, is in the best interests of the Board and of the County of Weld, State of olorado. The Board', of Weld County Commissioners shall give preference to resident. Weld County bidders in, I c es where the bids are competitive �ivin price and quality. Signature of Authorized Representative: Date of Signature: 2 12. I (7 Please indicate the program area(s) you wish td be considered for: ❑ Aftercare Services ❑ Anger Management/Domestic Violence • Crisis Intervention and Stabilization Services ❑ Day Treatment ❑ Foster Parent Consultation } Foster Parent Training ❑ Functional Family Therapy ❑ Home -Based Intensive Services ❑ Home Studies ❑ Kinship Services ▪ Life Skills ❑ Mediation ❑ Mental Health Services • Monitored Sobriety Only ❑ Multi -Systemic Therapy % Relinquishment Counseling ❑ .Sexual Abuse Treatment ❑ Substance Abuse Evaluation and Treatment ❑ 'Other: ❑ Other: ❑ Other: w Adoption Options Embravinr, Cbo;ce:. Emitiii:u; Lirt„ SINCE 1981 March 15, 2016 Weld County Department of Human Services Resource Unit, Attn: Tobi Vegter P.O. Box A 315 A North 11th Avenue Greeley, CO 80631 RE: Relinquishment Counseling Services for RFP Dear Mr. Vegter: On behalf of Adoption Options, a 501©3 non-profit agency, I am applying to provide relinquishment counseling services as described in the Request for Proposal (RFP) due March 25, 2016. Adoption Options is an inclusive non-profit adoption agency dedicated to enriching the lives of children, youth, and families. We provide education, placement services, counseling, and support for all members of the adoption community. Adoption Options has been in the community for 35 years and we have placed over 1,700 children into their permanent families. We have qualified staff and supervisors who work with many different family situations every day. Adoption Options has provided relinquishment counseling to over 5,000 birth families looking at making a plan of adoption for their baby or child. We have provided relinquishment counseling for families in the child welfare system in over 15 counties all over Colorado through contracts similar to this one. Adoption Options is more than qualified to provide this service for Weld County. The physical address for Adoption Options is 13900 E. Harvard Ave., Ste. 200, Aurora, CO 80014; however, our services cover the entire state of Colorado. Our office hours are Monday through Friday from 8:00 a.m. to 5:00 p.m. and there is coverage 24 hours a day, 7 days a week. We have counselors who cover the western slope as well as counselors housed in the Aurora office who cover the rest of the state. I, as the Executive Director, have over 25 years of experience in child welfare, including 15 years working for the county department of social services in Colorado and Indiana. I have been with Adoption Options for a total of seven years and have been in the Executive Director role for the last four years. I earned a MSW from University of Denver in 1996 and I have been a licensed clinical social worker since 2000. Lori Devlyn, Assistant Director and Placement Supervisor, has over 20 years of experience in child welfare with 15 years at Adoption Options. She has a Master's degree in Social Work and supervises the birth parent counselors and adoption caseworkers. Adoption Options currently has one birth parent counselor. Diana Alcala. Ms. Alcala holds a Bachelor degree in the social sciences. Diana Alcala is our senior birth parent counselor and has counseled over 100 birth parents considering relinquishment. She is fluent in Spanish and we are able to offer this to our families. AL Adoption Options lira, SINCE 1991 Adoption Options is an inclusive agency and the ONLY agency in Colorado that has earned our Seal of Recognition from the Human Rights Campaign Foundation as a recognized leader in the LGBT community. We take great pride in our ethical, non -biased approach to families and currently practice the "Strengthening Families' model. I look forward to working closely with Weld County around relinquishment counseling services if we are awarded the contract. Sincerely. Adrienne Elliott. I,CSW Executive Director Adoption Options c. . AdoptionOptions Em Gmtin CLalecs. :.lies. SINCE 1981 Part II of the RFP proposal for Relinquishment Counseling 5. Current resumes for Adrienne Elliott, Lori Devlyn, and Diana Alcala (attached), Licensure for Adrienne Elliott (attached) 6. Supervisory Structure: (organizational chart attached) Lori Devlyn is the Placement Supervisor for Diana Alcala. Ms. Devlyn is currently supervising 3 additional adoption caseworkers and will be supervising the birth parent counselor we are in the process of hiring. All of her staff members are full-time. Adoption Options does not utilize contract workers. Supervision currently consists of weekly supervision with each person individually and if needed, more frequently. Lori Devlyn is a MSW and has been a Placement Supervisor for over 8 years. Adrienne Elliott is the Executive Director of Adoption Options and supervises five full time staff members; one is Lori Devlyn, two Placement Supervisors for other programs in the agency, one Senior Accountant, and one Administrative Assistant/Human Resources Manager. Ms. Elliott has weekly individual supervision with her team. Ms. Elliott has been a Supervisor for over 15 years. 7. Adoption Options has one very skilled relinquishment counselor and is in the process of hiring another birth parent counselor who is skilled in working with both voluntary and non - voluntary hirthparcnts. Adoption Options has received other contracts throughout Colorado for Relinquishment only counseling. Adoption Options has 35 years of doing business in Colorado and our reputation is one of being ethically conscious. We are a large organization and are able to travel to all areas of the State of Colorado. We are in good standing with the State of Colorado (please see attached license and letter of good standing). 8. Rate Structure/Mileage: Adoption Options charges $400.00 per client/family for relinquishment counseling. This rate includes the counseling that meets the Court requirements (Relinquishment Counseling Report), the legal paperwork needed to file with the Court, and the length of time needed to fully counsel the individual. If there is a child that needs to be seen or counseled due to being over the age of 12, then Adoption Options would conduct that interview at $75.00 an hour in addition to the $400.00. Adoption Options charges .55 cents a mile over 70 miles from the Aurora office (13900 E. Harvard Ave.). If a client wanted to meet in our office we would not charge mileage. Adrienne Elliott, LCSW aelliottaadoption-options.com Cell: 303-929-5833 Curriculum Vitae Adoption Options, Aurora, Colorado, February 2012 -Present and November 2005 - 2009 Executive Director (Present) and Assistant Director/Placement Supervisor 2005-2009 Oversee and manage the daily operations of a non- profit licensed child placement agency with a budget of $1,200,000 a year. In 2012, built a foster to adopt program that has over forty families certified ready to adopt a child from foster care. Give presentations nationally covering areas of child abuse, neglect, foster care and adoption. Responsible for bringing in new revenue to the Agency including overseeing events and fundraising and writing grants. Report to a Board of Directors. Assist in managing and supervising a non-profit agency, implement and administer programs, and evaluate budgets and finances. Responsible for recruiting, hiring and training employees. Event planning and fundraising. One of two SAFE trainers in Colorado through the Consortium for Children. Develop strategic plans for expanding programs and outreach to the community. Seek, secure and manage grants. Personally organized and detail - oriented, while being creative and innovative. Metropolitan State College of Denver, School of Social Work, Denver, Colorado 2009-2015 Adjunct Faculty Teach an online class on" Introduction to Family Social Work", beginning the fall quarter of 2010 and every semester since. This is an introductory course designed to help beginning social workers learn how to do a needs based assessment determining the family's needs, how to engage, evaluate, and work with a variety of family dynamics including domestic viobnce, abuse of a child, poverty and crisis social work. Teach an online class on "Record Keeping" for the fall of 2012. University of Denver Graduate School of Social Work, Denver Colorado 2012-2014 Adjunct Faculty Teach two classes on "Maltreatment and Intake Assessment" and "Foster Care and Adoption" to 2n° year graduate students working to get their Masters in Social Work. These classes were focused in the child welfare track. Masters Degree — Social Work Bachelors Degree— Child Development Butler Institute of Families, University of Denver Graduate School of Social Work, Denver, Colorado 2009-2012 Training Specialist Trained curriculum for child welfare staff, foster parents, and other professionals in the social service arena, several times a year, covering areas of child abuse, neglect and adoption. Currently train the Adoption Certificate Program geared to mental health professionals and caseworkers in partnership with University of Denver, State of Colorado and the Adoption Exchange. Adoption Exchange, Aurora, Colorado, 2007-2009 Contract Trainer Trained curriculum for child welfare staff, foster parents, and other professionals in the social service arena, several times a year, covering areas of child abuse, neglect and adoption. Jefferson County Division of Children Youth and Families, Denver, Colorado, 2000.2005 Supervisor of the Adoption Team Managed and supervised employees, developed, implemented and evaluated programs, and administered program budgeting and financing. Responsible for recruiting, hiring and training employees. Developed presentations and conducted trainings to internal employees and customers. Engineered organizational changes. Mediated employee disputes. Extensive knowledge of the child welfare system including investigation of child abuse and neglect, policy and legislation and court procedures that contributes to the impact of child welfare. Jefferson County Department of Human Services, Denver, Colorado, 1997-2000 Senior Caseworker Participated in change management; responsible for mentoring and training interns; testified in court hearings as expert witness over 50 times. Provided quality customer service skills, supervised program when Supervisor was absent; Educated adults on parenting techniques. Wrote extensive reports to the Court. Developed and coordinated a committee to address employee retention. Marion County Department of Social Services, Indianapolis, Indiana, 1993-1994 Caseworker Worked in intake Department investigating child abuse and neglect, wrote comprehensive reports for the Court; oversaw and managed 30 cases. Education: University of Denver School of Social Work Purdue University Consumer & Family Sciences ADRIENNE ELLIOTT 14346 W 69TH DRIVE, ARVADA, CO 80004 (303) 929-5833 nokonaspeeps@gmail.com QUALIFICATIONS SUMMARY Extensive experience in managing and supervising people. Executive Director qualifications in managing a successful non-profit organization focusing on foster care and adoption. Success in employee retention based on ability to resolve conflicts and create a flexible, open work environment. Developed programs, managed their implementation and evaluated their outcomes. Realistic budgeting and budget management. Manage, plan and monitor a budget of 1.2 million. Involvement in training programs, developing curricula and presenting materials. Demonstrated success in building high functioning teams, lowering employee turnover, and improving quality of services to clients. Utilize evidence based research to build strong adoption and training programs. Built strong programs around outreach and community education for birth families and adoption. Key competencies include: • Conflict Resolution • Personnel Management • Employee Training/Coaching Budgeting • Local and National Presenter • Utilize research for program evaluation • Program Development/Management • Project Financing • Retention Succession/Planning • Time Management • Presentations • Partnerships/Collaboration • • Fundraising Curricula Development SELECTED BUISNESS CONTRIBUTIONS Increased revenue by implementing new programs in one year. Developed, recruited and hired staff to execute a foster to adopt program in the Agency. Wrote policies and procedures that are evaluated by the State for compliance. Result: Increased families applying to the program by 100% and placed nine children in six months from the foster care system. Currently the program has placed 35 children with adoptive families and has increased the waiting families to over 50; all in less than three years. Built capacity in the organization by increasing services. Increased staff, developed partnerships and evaluated new systems through strategic planning with staff and the board of directors. Result: Increase placement of children from 23 to 47 (80%) in one year and were able to build strong partnerships across state lines. Began a marketing campaign to rebrand logo and tag line of organization. Increased our online presence, developed a new logo, and began working on ways to increase our presence more nationally. Result Ongoing. In six months since implementation, we have increased our social media to reach birth parents and community members which has increased levels of activity within the agency by 20%. Partnered with Human Rights Campaign to become the only Colorado Agency to receive the "seal of recognition" that supports gay and lesbian adoption. This allows for National recognition for the Agency. Result: Ongoing. Increase in families applying to adopt to Agency by 30% and an increase in exposure on the State and National level. Prepared customized training presentations for large groups several times a year. Developed curriculum based on client needs; enhanced presentations to include full range of material; presented to several groups of employees; collected information from trainees for evaluation. Result: Conveyed more information and held larger training meetings during the year, which resulted in serving 20% more clients. Adrienne Elliott Resume, Page Two PROFESSIONAL EXPERIENCE Adoption Options, Aurora, Colorado, 2012 -Present Executive Director • Oversee and Manage the daily operations of a non-profit licensed child placement agency with a budget of $1..200,000 a year • In 2012, built the a foster to adopt program that has over twenty families certified ready to adopt a child from foster care • Give presentations nationally covering areas of child abuse, neglect, foster care and adoption • Responsible for bringing in new revenue to the Agency including overseeing events and fundraising and writing grants. Report to a Board of Directors Metropolitan State College of Denver, School of Social Work, Denver, Colorado 2008-2015 Adjunct Faculty • Teach an online class on" Introduction to Family Social Work", beginning the fall quarter of 2008 and every semester since. This is an introductory course designed to help beginning social workers learn how to do a needs based assessment determining the family's needs, how to engage, evaluate, and work with a variety of family dynamics including domestic violence, abuse of a child, poverty and crisis social work. Teach an online class on "Record Keeping" for the fall of 2012, Butler Institute of Families, University of Denver Graduate School of Social Work, Denver, Colorado 2009 - Present Training Specialist • Trained curricula for child welfare staff, foster parents, and other professionals in the social service arena, several times a year, covering areas of child abuse, neglect and adoption. Currently train the Adoption Certificate Program geared to mental health professionals and caseworkers in partnership with University of Denver, State of Colorado and the Adoption Exchange Adoption Exchange, Aurora, Colorado, 2007-2009 Contract Trainer Trained curriculum for child welfare staff, foster parents, and other professionals in the social service arena, several times a year, covering areas of child abuse, neglect and adoption. Adoption Options, Aurora, Colorado, 2005-2009 Assistant Director/Placement Supervisor • Assist in managing and supervising a non-profit agency, implement and administer programs, and evaluate budgets and finances. Responsible for recruiting, hiring and training employees. Event planning and fundraising. One of two SAFE trainers in Colorado through the Consortium for Children. Develop strategic plans for expanding programs and outreach to the community. Seek, secure and manage grants. Personally organized and detail -oriented, while being creative and innovative. Jefferson County Division of Children Youth and Families, Denver, Colorado, 2000-2005 Supervisor of the Adoption Team • Managed and supervised employees, developed, implemented and evaluated programs, and administered program budgeting and financing. Responsible for recruiting, hiring and training employees. Developed presentations and conducted trainings to internal employees and customers. Engineered organizational changes. Mediated employee disputes. Extensive knowledge of the child welfare system including investigation of child abuse and neglect, policy and legislation and court procedures that contributes to the impact of child welfare. Adrienne Elliott Resume, Page Three Jefferson County Department of Human Services, Denver, Colorado, 1997-2000 Senior Caseworker • Participated in change management; responsible for mentoring and training interns; testified in court hearings as expert witness over 50 times. Provided quality customer service skills, supervised program when Supervisor was absent; Educated adults on parenting techniques. Wrote extensive reports to the Court. Developed and coordinated a committee to address employee retention. Cleo Wallace Center, Denver, Colorado, 1996-1997 Clinician • Responsible for program development and implementation; administered daily operations on hospital floor; utilized community resources for aftercare services. Wrote detailed reports; implemented policies and procedures for managed care hospital. Counseled children and families in crisis. Researched new and innovative strategies in working with out of control youth. Marion County Department of Social Services, Indianapolis, Indiana, 1993-1994 Caseworker Worked in intake Department investigating child abuse and neglect, wrote comprehensive reports for the Court; oversaw and managed 30 cases. Educated the community on child abuse and neglect. Testified in court as an expert witness. Prior experience includes grant management and utilization of funds, event planning and mediation skills. EDUCATION LCSW, obtained January 2000 MSW, University of Denver, Denver, Colorado Social Work Graduated with Honors BS, Purdue University, West Lafayette, Indiana Consumer and Family Sciences References Provided Upon Establishment of Mutual Interest Cut along the line Colorado Department of Regulatory Agencies Division of Professions and Occupations Social Work Examiners Board Adrienne S. Elliott Licensed Clinical Social Worker CSW.00992339 09/01/2015 Number Issue Date Active 09/31/2017 Credential Status Expire Date Verify this credential at: vow w ra.o: ern ad:r'nviluulrs; rills D14ision Director: Lauren Larson Credential Holder Signature Colorado Department of Regulatory Agencies Division of Professions and Occupations Social Work Examiners Board Adrienne S. Elliott Licensed Clinical Social Worker CSW.00992339 09/01/2015 Number Issue Date Active 08/31/2017 Credential Status Expire Date Verify this credential at: w'ww dun; raL railiutm /iii __ ision Director: Lauren Larson Credential Holder Signature 15(i)Nr.,ir:w.,,. Suit, 1457. t?J1v1 I. (O30,nd P101r;1MH0 I `D;.tY4iM)l vrvrvr. 1a,t a dnr.u!,:-, rv�pr,rf..v.ills LORIANN DEVLYN, 10757 Chadsworth Lane 0 Highlands Ranch, Colorado 80126 0 Ldevlyn@gmail.com 0 720.530.8815 OBJECTIVE: Social Work Representative SUMMARY OF QUALIFICATIONS & SKILLS Detail and result oriented professional with broad experience in human services field. Offering expertise in working with individuals, families and professionals in both stressful and often emotional life circumstances. Strengths in assessment and conflict resolution. Excel in a fast paced environment managing multiple responsibilities with efficiency, accuracy and in a timely manner. Versatile and highly proficient in establishing and maintaining relationships within all areas of the community and healthcare industry. Excellent interpersonal skills at -all organizational levels. Strong ability to work in teams and confident in working independently. Excellent work ethic. REPRESENTATIVE EXPERIENCE V Individual/family assessment ✓ Coordinate and facilitate adoptive placements ✓ Crisis intervention ✓ Volunteer and fund-raising coordinator ✓ Conduct education groups/seminars ✓ Initiate and maintain all legal requirements representing the agency ✓ Implement marketing strategies for a nonprofit agency ✓ Promote ongoing communication with multidisciplinary teams V Working with healthcare professionals PROFESSIONAL HISTORY March 1, 2014— Present Adoption Options, CO Assistant Executive Director October 1, 2011— Adoption Options, Aurora, CO Placement Supervisor August 1, 2010 — October 1, 2011, Adoption Options, Aurora, CO Birth Parent Counselor and Adoptive Family Caseworker September 4, 2007 —August 2009, Adoption Options, Aurora, CO Adoptive Family Caseworker August 2005 —September 4, 2007, Douglas County School District, Highlands Ranch, CO Substitute Teacher; grades K — 6 EDUCATION Master of Social Work, University of Denver (1995) Bachelor of Arts, University of Wisconsin -Stevens Point (1985) CIVIC & SERVICE ORGANIZATIONS Parent Teacher Organization Volunteer Urban Peak Volunteer Church Blood Drive Chairperson Other Volunteer Activities —Assisted youth soccer coach, meals to the homebound, participate in many school -related activities and programs. INTERESTS Golf, Tennis, Camping, Skiing, Physical Fitness, Reading DIANA ALCALA ALCALADAI@YAHOO.COM 303.475.9763 850 S. PEARL ST.#8 DENVER CO 80209 EDUCATION Bachelor of Arts in Anthropology; Minor Sociology University of Northern Colorado Graduation Date: December 11, 2010 PROFESSIONAL EXPERIENCE Arapahoe/Douglass Mental Health, Acute Care Campus 2014 -Present Milieu Counselor/Mental Health Technician • Provide support of milieu management and assistance with daily living skills to patients at an Acute Treatment Unit in cooperation with a multi -disciplinary team. Ensure patient safety by monitoring patient's behaviors and actions. Assist patients in assessing their ability to perform duties independently and teach new skills. Complete admission and discharge paperwork. Support patients with individual therapeutic tasks such as WRAP plan, relaxation skills, coping skills. Provide skill building activities and groups. Adoption Options Birth Parent Counselor 2013 -Present • Provide counseling to birth parents during the decision making process of adoption. Connect clients with proper housing, food, and insurance resources and/or programs. Offer support and guidance through different stages of pregnancy. Complete required pre and post placement assessments, including required legal documentation. Present observations, conclusions and recommendations. Coordinate placement of infants into cradle (foster) care. Submit court reports and attend court hearings when necessary. Refer birth parents to available community resources. Maintain up-to-date files as required by state regulations. Legal Liaison 2012-2014 • Prepare court documents for adoption finalizations with adoptive families. File and track documents with the court. Plan and coordinate annual Adoption Day in Court event. Work directly with court clerk to prepare for and complete adoption finalization hearings. Volunteer Coordinator 2014 -Present • Recruit and retain volunteers in volunteer program. Maintain updated volunteer records. Deliver trainings to volunteers. Administrative Assistant 2011-2012 • Greet and provide clients with agency information. Sort and distribute mail. Maintain agency database. Manage communication/correspondence between birth parents and adoptive families. Complete general office tasks. SKILLS Bilingual- Fluent in Spanish language Exceptional interpersonal, presentation, time management, and organizational skills Verbal and written communication skills Proficient with MS Word, Excel, PowerPoint, and Access Tech savvy, with ability to quickly learn new software applications Team player who can adapt in changing situations Experience with court testimony and documentation TRAININGS and CERTIFICATIONS Solution Focused Therapy, 2016 Advanced Strategies Motivational Interviewing, 2016 Confidentiality and HIPAA, 2015 Co -Occurring Disorders, 2015 Human Rights Campaign Training, 2015 Intellectual Disabilities, 2015 Illness Education 2980, 2014 Fundamentals of Traumatic Brain Injury, 2015 First Aid & CPR, 2014 Adult Protective Services- Mandatory Reporting, 2014 Cultural Diversity, 2014 Grief & Loss, 2014 Non -Violent Crisis Intervention CPI -8, 2014 Colorado Notary Public, 2013 Worker -Client Safety in Human Service Setting, 2013 SAFE Certification, 2012 REFERENCES Will provide upon request. Adoption Options Organizational Chart 2015 Courtney E.W. G a.. CC N C C u ea -LL ' C L ' CO a Y O I ea 3` U y n N zn CO ' v u o v m a F m OFFICE OF THE SECRETARY OF STATE OF THE STATE OF COLORADO CERTIFICATE OF FACT OF GOOD STANDING I, Wayne W. Williams, as the Secretary of State of the State of Colorado, hereby certify that, according to the records of this office, ADOPTION OPTIONS is a Nonprofit Corporation formed or registered on 06/16/1981 under the law of Colorado, has complied with all applicable requirements of this office, and is in good standing with this office. This entity has been assigned entity identification number 19871440340 . This certificate reflects facts established or disclosed by documents delivered to this office on paper through 12/15/2015 that have been posted, and by documents delivered to this office electronically through 12/17/2015 @ 08:49:26 . I have affixed hereto the Great Seal of the State of Colorado and duly generated, executed, and issued this official certificate at Denver. Colorado on 12/17/2015 @ 08:49:26 in accordance with applicable law. This certificate is assigned Confirmation Number 9417792 Secretor)' of Stale of the Slate oleulorodo «,«.««..***.«««««««««. ************• **********End of Certilicaterrr««««««««««.««««.««««««.««««««««««««««««x ;Vance: .4 certrficare issued elecovnlcalle Irvin the Colorado Secretory of State's Web site Is fully and immediately valid and effective. !louvre,' as an option, the issuance and readily of a certificate obtained electronically may be established hr visiting the I abdate n C'ernfirate page of the Secremir of. S'tate's Web she, hap: uvn.sos.stare.ca.ra hirCertfcate.S'enrchCrtteria.da entering the certificate's confirmation number displayed an the certificate. and following the instructions displayed. Confnrmine the issuance ofa certificate is merely optional and is not necessar7_ to the valid and effective issuance of a certificate. For more information. visit our Web site. hulk,' nvvar.sos.state.co.us click "Businesses. trademarks. trade names" and select "Frequently Asked Ouesnans. " STATE OF COLORADO DEPARTMENT OF HUMAN SERVICES OFFICE OF EARLY CHILDHOOD DIVISION OF EARLY CARE AND LEARNING 1575 SHERMAN STREET DENVER, COLORADO 80203-1714 TIME LIMITED CHILD CARE LICENSE Provider ID: 45078 Service Type: CHILD PLACEMENT AGENCY FOSTER CAR ADOPTION OPTIONS 13900 EAST HARVARD AURORA, COLORADO 80014 COUNTY: ARAPAHOE LOCATION: 13900 EAST HARVARD AURORA, COLORADO 80014 COUNTY: ARAPAHOE License Effective Date: 05-03-2015 License Expiration Date: 05-03-2016 The licensee must comply at all times with the Child Care Act and the rules and standards of the Department of Human Services. The licensed premises and its records must be available for inspection at all times by the Department of Human Services or Its authorized representatives. This license is valid only for the location address listed above and is not transferable to any other person, organization or location. The licensee must surrender this license to the Department of Human Services upon denial, revocation or suspension. Numbers and ages of children cared for at the licensed premises must not at any time exceed: Other conditions and restrictions: CPA approved to place for adoption and foster care Unique conditions: Approved for intercountry adoptions 5/4/2015 EXECUTIVE DIRECTOR APPROVAL DATE THIS LICENSE MUST BE POSTED IN A PROMINENT LOCATION ON THE LICENSED PREMISES Capitol Specialty Insurance Corporation COMMERCIAL GENERAL LIABILITY P.O Box 5900. Madison. WI 53705 COVERAGE PART DECLARATIONS TRANSACTION TYPE: New Business ENDORSEMENT #: 000 POLICY NUMBER H502509922-01 NAMED INSURED AND ADDRESS Adoption Options 13900 E Harvard Ave Sle 200 Aurora, CO 80014-2325 POLICY PERIOD 04/01/2015 - 04/01/2016 12:01 A.M. Standard Time at the address of the insured stated herein. AGENCY/PRODUCER CODE 65612 AGENCY/PRODUCER CRC Insurance Services, Inc 1 Metroplex Dr Ste 400 Birmingham AL 35209-6895 Form of Business: Not for Profit Org Business Description: Adoption and Foster Care Placements General Aggregate Limil (Other Than Products -Completed Operations) Products -Completed Operations Aggregate Limit Personal And Advertising Injury Limit Each Occurrence Limit Damage To Premises Rented To You Limit Medical Expense Limit $ 3.000,000 S 3.000,000 $ 1.000,000 S 1,000,000 S 100,000 Any One Fire $ 5,000 Any One Person Location of all Premises You Own, Rent or Occupy: SEE ATTACHED LOCATION FORM SCHEDULE CICG 176 Classification Code No. Premium Rate Advance Premium Basis Pr/Co Pr/Co Other SEE ATTACHED COMMERCIAL GENERAL LIABILITY SCHEDULE CICL 043 Balance To Meet Minimum S 0.00 TOTAL ADVANCE PREMIUM S 2.540.00 THE LIABILITY PREMIUM BASIS OF THIS POLICY IS SUBJECT TO AN AUDIT. ADDITIONAL PREMIUM MAY BE DUE. FORMS AND ENDORSEMENTS: SEE COMMERCIAL GENERAL LIABILITY COVERAGE PART FORM SCHEDULE CICL 044 CICL 042 (04-11) COUNTERSIGNED 04/02/2015 By Authorized Representative Copyright 2010, Capitol Transamerica Corporation, Inc. Page 1 of 1 Capitol Specialty Insurance Corporation COMMERCIAL GENERAL LIABILITY SCHEDULE P.O. Box 5900, Madison, WI 53705 TRANSACTION TYPE: New Business ENDORSEMENT ft: 000 POLICY NUMBER HS02509922-01 POLICY PERIOD 04/01/2015 - 04/01/2016 12:01 A.M. Standard Time at the address of the insured stated herein. AGENCY/PRODUCER CODE 65612 NAMED INSURED AND ADDRESS Adoption Options 13900E Harvard Ave Ste 200 Aurora. CO 80014-2325 AGENCYIPRODUCER CRC Insurance Services, Inc. 1 Metroplex Dr Ste 400 Birmingham AL 35209-6895 Prems No. Classification 1 1 2 3 Buildings or premises - Office - Not for profit Sales or service organizations Buildings or premises • Office • Not for profit Buildings or premises - Office - Not for profit Employee Benefit Liability Code Premium No. Basis 61227 3,452 Area 47367 150,000 Payroll 61227 240 Area 61227 1,697 Area 1 Non -Owned Auto Including Hired Auto 00984 General Liability Enhancement Endorsement Rate Pr/Co Other 319.651 0.822 319.6651 319.651 $ 1,000,000 $ 1,000,000 Occurrence Aggregate Limit Limit $ 1,000,000 $ 3,000.000 Occurrence Aggregate Limit Limit Balance To Meet Minimum Premium Total Advance Premium Minimum Earned Premium $ 1,000 Deductible Advance Premium Pr/Co Other $ 0.00 $ 1,104.00 $ 0.00 $ 124.00 $ 0.00 $ 76.00 $ 0.00 $ 543.00 $ 211.00 $ 232.00 $ 250.00 $ 0.00 $ 2,540.00 N/A CICL 043 (02-11) Page 1 of I Copyright 2010, Capitol Transamerica Corporation, Inc. EXHIBIT C SCOPE OF SERVICES 1. Contractor will provide Relinquishment Counseling to Weld County individuals, age 12 years of age or older, as referred by the Department. 2. Relinquishment counseling services will be provided to all adult individuals referred by the Department, as well as associated children 12 years of age and older, utilizing the required State format. Contractor will submit a written report and the appropriate affidavits and interrogatories as required by the Courts. 3. Contractor is located at 13900 East Harvard Avenue, Suite 200, Aurora, Colorado 80014, however services are available throughout Colorado. 4. Contractor has bilingual staff and can provide services in Spanish. 5. Contractor is sensitive to family ethnicity, culture, values and beliefs. 6. 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. 7. Contractor will document in detail any and all observed or verbalized concerns regarding any child whom the Contractor is working with under an active referral. Areas of concern may include, but are not limited to, any physical, emotional, educational or behavioral issues. Areas of concern should be reported immediately AND on the required monthly report. 8. Contractor understands that the Department does not reimburse for cancelled appointments, either on the part of the client or the Contractor. 1 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 $400.00/Episode (Relinquishment Counseling. Inclusive of all counseling, paperwork and time required to complete the service.) $75.00/Hour (Additional hourly rate to counsel child, 12 years of age or older.) $ .54/Mile (Rate per mile over 70 miles from 13900 East Harvard Avenue, Aurora, Colorado 80014.) 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 7'h 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. 2 '`'�� o CERTIFICATE OF LIABILITY INSURANCE DATEIMM/DDIYYYY) 7/27/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Hawley 6 Associates, LLC 11911 NE 1st St., Ste. B102 Bellevue WA 98005 CONTACT Canl Naciolek NAME: ONE No Eat), (425) 462-4758 FAX (425)462-4783 IN Noy MAjess:cmaciolek@hawleyandassociateses,com INSURER(S) AFFORDING COVERAGE NAIC 0 INsuRERACapitol Spec Ins Corp 10328 INSURED Adoption Options 13900 E. Harward Ave Suite 200 Aurora CO 80014 INSURER e : INSURER C: INSURER O: INSURERS: INSURERF: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDLSUBR INSD MD POLICY NUMBER POLICY EFF IMM/DDIYYYY) POLICY EXP IMMIDDII'YVY) LIMITS A X COMMERCIAL GENERAL X LIABILITY OCCUR 8502509922-02 4/1/2016 4/1/2017 EACH OCCURRENCE 5 2,000,000 J CLAIMS -MADE DAMAGE TO RENTED PREMISES 5 100, 000 (Ea occurrence) MED EXP (Any one person) $ 5,000 PERSONAL BADV INJURY S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: - LOC GENERAL AGGREGATE 5 4,000,000 X PRO POLICY JECT OTHER: PRODUCTS - COMP/OP AGG S 4,000,000 Employee Benefits S 1,000,000 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS H gpSED PROPERTY DAMAGE (Per accident) 5 $ UMBRELLA LIAR EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE S AGGREGATE 5 DED I I RETENTIONS 5 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS Y/N N/A PER OTH- I STATUTE I ER E.L. EACH ACCIDENT S below EL. DISEASE - EA EMPLOYEE S E.L. DISEASE - POLICY LIMIT S A A Professioinal Liability Sexual Abuse Liability E502509922-02 8502509922-02 4/1/2016 4/1/2016 4/1/2017 4/1/2017 Each Occ/Gen Agg $2Mi1 / $4t4i1 Each Occ/Gen Agg $100k / $300k DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) Certificate Holder is included as an additional insured as their interest may appear. Coverage is Primary and Non -Contributory and Waiver of Subrogation Applies. CANCELLATION Weld County Department of Human Services 315 A. North 11th Ave. Greeley, CO 80631 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 Phillip Hawley/CSR ACORD 25 (2014/01) INS0251?n16011 © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Hello