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Home My WebLink About20162037.tiffe'en -kid- /64 -5 -oz Esther Gesick From: Sent: To: Subject: FYI below. Cecilia Moreno Thursday, October 06, 2016 4:14 PM Esther Gesick FW: Woodard - Termination of Contract Cecilia Moreno Employment Services Support Specialist Employment Services of Weld County 315 N 11 Ave 8 Greeley, CO 80631 970-353-3800 ext. 6756 Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. If you have received this communication in error, please immediately notify sender by return e-mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited. From: Tobi Vegter Sent: Thursday, October 06, 2016 2:47 PM To: Cecilia Moreno <cgarcia-moreno@co.weld.co.us> Cc: Tobi Vegter <vegterta@co.weld.co.us>; Lesley Cobb <cobbxxlk@co.weld.co.us> Subject: Woodard - Termination of Contract Hi Ceci, Jennifer Woodard, a home study and relinquishment counseling contractor, has terminated her contract with Weld County. She provided the letter below. What else do you need from us? Thank you. Regards, Tobi Vegter Child Welfare Contract and Services Coordinator Weld County Department of Human Services Division of Child Welfare Resource Unit (970) 352-1551, ext. 6392 (970) 301-2676 (Cell) (970) 346-7667 (Fax) veaterta(a-weldaov. corn &Y)U744U1 ;Cart.;nt.41 /o-/2 -.20t, 1 020/6- ao37 ,/,eoolf7 Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. If you have received this communication in error, please immediately notify sender by return e-mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited. From: Jenny Woodardjmailto:ienniferholly.w@gmail.com] Sent: Monday, October 03, 2016 8:36 AM To: Tobi Vegter <vegterta@co.weld.co.us> Subject: Letter 2 October 3, 2016 Weld County Department of Human Services Attn:Tobi Vegter Dear Tobi, I have a few home studies to get in to you that are pending but I can no longer take on any new ones. I am just too busy with my regular job to complete home studies at this time. I have enjoyed working with you all and truly appreciate the opportunity. Please let me know if there is anything I need to do or paperwork that I need to complete on my end to terminate my contract. Again, thank you so much. Jennifer Woodard, LCSW, LLC ire 3 CONTRACT AGREEMENT AMENDMENT BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND SAVIO (Core) 7� This Agreement Amendment, made and entered into oZ7 day of 2016, by and between the Board of Weld County Commissioners, on behalf of the Weld �De y Depart ment of Human Services, hereinafter referred to as the "Department", and Savio, hereinafter referred to as the "Contractor". WHEREAS the parties entered into an Agreement for Foster Parent Consultation, Functional Family Therapy, Home Based Intensive Services, Life Skills, Mental Health Services, Multisystemic Therapy, and Sexual Abuse Treatment, (the "Original Agreement") identified by the Weld County Clerk to the Board of County Commissioners as document No. 2014-3046, approved on October 6, 2014. WHEREAS the parties hereby agree to amend the term of the Original Agreement in accordance with the terms of the Original Agreement, which is incorporated by reference herein, as well as the terms provided herein. NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows: • The Original Agreement ended on May 31, 2015. • The Original Agreement was renewed for the term of June 1, 2015 -May 31, 2016. The Agreement Amendment is identified by the Weld County Clerk to the Board of County Commissioners as document No. 2015-1849, 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. Exhibit B, Scope of Services, Item 3 i. Functional Family Therapy is also available with Contingency Management; a specific model to work with referred clients with substance abuse issues. G&:0 -4_6(12.e. /4-5p ,„27 2016-2037 (1) /eo a l 3. Exhibit B, Scope of Services, Item 8 j. Multisystemic Therapy is also available with Contingency Management; a specific model to work with referred clients with substance abuse issues. 4. Exhibit C, Payment Schedule, Item 2 -Fees for Service. Functional Family Therapy: $910.00/Month (Functional Family Therapy, pro -rated for partial month of service) $1,210.00/Month (Functional Family Therapy -Contingency Management, pro -rated for partial month of service) Multisystemic Therapy: $1,750.00/Month (Multisystemic Therapy, pro -rated for partial month of service) $1,950.00/Month (Multisystemic Therapy -Contingency Management, pro -rated for partial month of service) $2,637.00/Month (Multisystemic Therapy -Problem Sexual Behavior, pro -rated for partial month of service) • All other terms and conditions of the Original Agreement remain unchanged. CONTRACT AGREEMENT AMENDMENT BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND SAVIO (Core) IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first above written. ATTEST: Weld C By: dale.%) ty lerk to the Board WELD COUNTY, COLORADO COUNTY: BOARD OF COUNTY COMMISSIONERS Deputy Cler Mike Freeman, Chair JUN 2 7 2016 CONTRACTOR: Savio 325 King Street Denver, Colorado 80219 (303) 225-4200 By: Date: William S. Hildenbrand, Executive Director o2oi‘, - z os1(i) ,AL -G•121:::•. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDNYYY) 05/02/2016 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 have ADDITIONAL INSURED provisions or 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 AOn Risk Insurance services West, Inc. Denver CO Office 1900 16th Street, Suite 1000 Denver Co 80202 USA CONTACT NAME. (A/C. o.Ext); (303) 758-7688 I F( �). (303) 758-9458 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIL N INSURED Savio House 325 King Street Denver Co 80219 USA INSURERA Philadelphia Indemnity Insurance Company 18058 INSURER EL Pinnacol Assurance Company 41190 INSURER C: INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570061997625 REVISION NUMBER: 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 CONTRACTOR 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. Limits shown areas requested elan LTR TYPE OF INSURANCE ADDL p,L4D SUER WVD POLICY NUMBER POLICY EFF MMIDD POLICY EXP IAWY DlYVYY LIMITS A X COMMERCIAL GENERAL LIABILITY PHPK1489141 bS/Ul/2Ulb 85/�1/201, EACH OCCURRENCE $1,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES (Es occurrence) $1,000,000 X Sexual Molestation coverage applies MED EXP (Any one person) $5,000 PERSONAL & ADV INJURY $1,000,000 GERL AGGREGATE LIMIT APPLIES PER; GENERAL AGGREGATE 53,000,000 X PRO- POLICY ❑ ❑ LOC JECT PRODUCTS-COMP/OP AGG $3,000,000 OTHER: A AUTOMOBILE LIABILITY PHPK1489141 05/01/201605/01/2017 COMBINED SINGLE' LIMIT (Ca accident) $1,000,000 X ANY AJTO BODILY INJURY ( Per person) OWNED A HIRED AUTOS ONLY -- NON -OWNED AUTOS ONLY PROPERTY DAMAGE (Per accident) _ Comprehensive Deduct $500 A X UMBRELLA LIAB X OCCUR PHUBS39014 05/01/201605/01/2017 EACH OCCURRENCE $10,000,000 EXCESS LIAB CLAIMS -MADE AGGREGATE $10,000,006 DEDI X (RETENTION 110,000 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY N 984642 05/01/2016 05/01/2017 X I PER I IOTH- STATUTE ER Y ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICERIMEMBER EXCLUDED? N N/A E.L. EACH ACCIDENT $500,000 (Mandatory In NH) if descnba E.L. DISEASE -EA EMPLOYEE $500, 000 yes, under DESCRIPTION OF OPERATIONS below El_ DISEASE -POLICY LIMIT $500,000. A Misc Liab Cvg PHPK1489141 05/01/2016 05/01/2017 Prof each Occ. Aggregate $1,000,000: $3,000,000) DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) State of Colorado/Department of Human Services and Weld Adolescent Resources, Inc. are included as Additional Insured as : required by written contract, but limited to the operations of the Insured under said contract, per the applicable endorsement with respect to the General Liability policy. I CERTIFICATE HOLDER CANCELLATION weld County Department of Human Services 315 A N. 11th Avenue PO BOX A Greeley CO 80632 USA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WALL 8E DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE t3r1A91 ✓Gf17VfG �Nd(LfL891G1S t�if apElfd X c.! ft4 ACORD 25 (2016/03) ©1988.2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Holder Identifier : • hivirod IQ* 50Q. CONTRACT AGREEMENT AMENDMENT BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND JENNIFER WOODARD, LCSW (Non -Core) (CA into 0 day Agreement Amendment, made and entered Y of May, 2016, by and between the Board of Weld County Commissioners i on behalf of the Weld County Department of Human , • "Department", and Jennifer Woodard, LCSW, hereinafter Services, hereinafter referred to as the p , referred to as the "Contractor". WHEREAS the parties entered into an Agreement for Home Studies and Relinquishment g Counseling, Ori Agreement") identified by the Weld County Clerk to the Board of County (the "Original g reement) Commissioners as document No. 2014-3046, approved on October 6. 2014. WHEREAS the parties hereby agree to amend the term of the Original Agreement in accordance with the terms of the Original Agreement, which is incorporated by reference herein, as well as the terms provided herein. NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows: • The Original Agreement ended on May 31, 2015. • The Original Agreement was renewed for the term of June 1, 2015 -May 31, 2016. The Agreement Amendment is identified by the Weld County Clerk to the Board of County Commissioners as document No. 2015-1612, approved on June 1, 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. e 44SD fieXA2--E-4-t a 7- 40 7-- &• • t e art1es ereto have dtily executed the A�reemeni as of theda , m0n�fb�_ and. year first •above written] ATTEST VBOARD OF COUNTY COMMISSIONERS ,leld Cpcnty Clerk to the Board WELD COUNTY/ COLORADO �e jjj n• 7 Jennifer Woodard, LCSIIII` 1530 Freedom Lane: Fort Collins, Colorado 8 d (970) 443-501 ACCPR El ® `..---- CERTIFICATE OF LIABILITY INSURANCE Ai_ (MM/DD/YVW) 6/3/2016 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(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. PRODUCER NASW RRG Plan Administrator 1200 East Glen Avenue Peoria Heights, IL 6161 6-5348 CONTACT NAME: PHONE FAX (NC, No,Ext): WC, No): E-MNL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURED Jennifer Woodard, LCSW LLC 1530 Freedom Lane Fort Collins, CO 80526 INSURER A: NASW Risk Retention Group 14366 INSURER B: INSURER C: INSURER D: INSURER E: INSURER F: CUSTOMER ID: 1 HGLDWVH32 CERTIFICATE NUMBER: P-GP01 KV18RVN3B-00 REVISION NUMBER: 001 THIS IS TO CERTIFY THAI THE POLICIES OF INSLRANCE LISTED BELOW HAVE BEEN ISSULD TO NIL INSURED NAMED ABOVE FOR THE POIICYPERIOD INDICATED- NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT 10 ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN RED„CED BY PAID CLAIMS. INSR LW TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YWY) POLICY EXP (MM/DD/YYYY) LIMITS GENERAL LIABILITY EACY OCCL.RREvCE $ DAMAGE TO RYNTP: PREMISES (Ea. Occ Jrrence) $ MED SUP ;Any ore aerson) WREONAL &ADV NIUYY $ GENERAL AGGREGATE $ H HI_ OCCUR °RODUYTS COMP/OPAGG S $ f -\'L AGGREGATE LIMIT APP! ES PER: PO._ CY n RROIECT n WC AUTOMOBILE _AUTOS LIABILITY ANY AUTO A- OWNED HIRED AUTOS - SCHEDULED AUTOS NON -OWNED AUTOS COMBINED S,`c_E sM't (Ea acCiderT, $ BODILY INJURY (per person) $ 3CD:_Y NIURY(Per acc dent) $ UROAERn' DAMAGE (Per acadert) $ _ �D UMBRELLA LIAB CESS D-.) LIAB n R_TENTON _ OCCUR CLAIMS MADE $ _ACC- OCCURRENER $ AGGRECAF_ 5 $ ]OTTER WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY rROPRIETOR/ BAR TXL7/ -XECUT'V- Or - (FR/ MEMBER RXC_UJED? f yes, aescrioe urger-._ (Mandatory In NH) Descoptior of Opeuatiors I WE STATUTORY LIMITS _ _� . DISEASE EACH EMPLOYEE $ DISEASE - POc.CY -MiT $ A Professional Liability Retroactive Date: 05/17/2013 Y N P-GRO1 KVI8RVN3B-00 05/17/2016 05/1 7/201 7 Professional Liability Per Claim Limit $2000000.00 / Professional Liability Aggregate Limit $4000000.00 / State Licensing Board Limits $50000.00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEI IICI ES CERTIFICATE HOLDER County of Weld 1150 `O' Street Greeley, Colorado 80631 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED ON ACCORDANCE WITH POLICY PROVISIONS. AuIHORIZEO P042 REPRESENTATIVE ijiipo ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Hello