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CONTRACT AGREEMENT AMENDMENT
BETWEEN
THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES
AND VICTOR H. CORDERO, PSY.D., P.C. (CORE)
This Agreement Amendment, made and entered into day of 2016, by and between
the Board of Weld County Commissioners, on behalf of the Weld Count Department of Human
Services, hereinafter referred to as the "Department", and Victor H. Cordero, Psy.D., P.C., hereinafter
referred to as the "Contractor".
WHEREAS the parties entered into an Agreement for Mental Health Services, (the "Original
Agreement") identified by the Weld County Clerk to the Board of County Commissioners as document
No. 2014-2476, approved on August 11, 2014.
WHEREAS the parties hereby agree to amend the term of the Original Agreement in
accordance with the terms of the Original Agreement, which is incorporated by reference herein, as
well as the terms provided herein.
NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as
follows:
• The Original Agreement ended on May 31, 2015.
• The Original Agreement was renewed for the term of June 1, 2015 -May 31, 2016. The
Agreement Amendment is identified by the Weld County Clerk to the Board of County
Commissioners as document No. 2015-1848, approved on June 24, 2015.
• The Amendment, together with the Original Agreement, constitutes the entire
understanding between the parties. The following change is hereby made to the Contract
Documents:
1. Term
This agreement shall become effective on June 1, 2014, upon proper execution of this
Agreement and shall expire May 31, 2017, unless sooner terminated as provided herein.
2. None
• All other terms and conditions of the Original Agreement remain unchanged.
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IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month,
and year first above written.
COUNTY:
ATTEST:
BOARD OF COUNTY COMMISSIONERS
Weld • unty Clerk to the : oard WELD COUNTY, COLORADO
By:
Deputy rk to the jj ` Mike Freeman, Chair
AUG 082016
Victor H. Cordero, Psy.D., P.C.
11178 Huron Street, Suite 202
Northglenn, Colorado 80234
(303) 455-9480
By:
Date:
Victor H. Cordero, Psy.D.
it LI2c3
02o/4,_ 02.557
Account Number: CO CORV 2820 Date: 7/14/16 Initials: KB
CERTIFICATE OF INSURANCE
ALLIED WORLD INSURANCE COMPANY
C/O: American Professional Agency, Inc.
95 Broadway, Amityville, NY 11701
800-421-6694
This is to certify that the insurance policies specified below have been issued by the company indicated
above to the insured named herein and that, subject to their provisions and conditions, such policies afford
the coverages indicated insofar as such coverages apply to the occupation or business of the Named insured(s)
as stated
THIS CERTIFICATE OF INSURANCE NEITHER AFFIRMATIVELY NOR NEGATIVELY AMENDS, EXTENDS OR
ALTERS THE COVERAGE(S) AFFORDED BY THE POLICY(IES) LISTED ON THIS CERTIFICATE.
Name and Address of Insured:
VICTOR H. CORDERO, PSY.D.
11178 HURON STREET
STE 202
NORTHGLENN CO 80234
Type of Work Covered: PROFESSIONAL PSYCHOLOGIST
Location of Operations:
(If different than address listed above)
Claim History:
N/A
Retroactive date is 05/21/2007
Additional Named Insureds:
Coverages
Policy
Number
Effective
Date
Expiration
Date
Limits of
Liability
PROFESSIONAL/
LIABILITY
5011-6206
5/21/16
5/21/17
1,000,000
3,000,000
NOTICE OF CANCELLATION WILL ONLY BE GIVEN TO THE FIRST NAMED INSURED, WHO SHALL
ACT ON BEHALF OF ALL INSUREDS WITH RESPECT TO GIVING OR RECEIVING NOTICE OF
CANCELLATION.
Comments: COUNTY OF WELD IS LISTED ON THIS POLICY AS AN ADDITIONAL
INSURED.
This Certificate Issued to:
Name: COUNTY OF WELD
1150 O STREETTREET
GREELEYENN CO 80631
APA 00138 00 (06/2014)
Address:
Autiorized Representative
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