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Home My WebLink About20161881.tiff("t )\ I R. A(iRF:L\IE\T \\IL\DyIENT RI.I\V'LEN THE \V LLD COt "NT ' DE1'AR1 \IFS:AT OF Hl \I \\ SIA\ ICES \\D 1:Ait'O\VI:RI\Ci (.I IOU IBS THLR,\I'1'. ILC (Core) This Agreement Amendment, made and entered into 3 _ day of \lav, 2t) 1 o, hhet vycen the Board of Weld County Commissioners, on hehalt of the Weld County Department of Flurllan Services, hereinafter referred to as the "Department'', and Enipowering Choices t herapy, LL( hereinafter referred to as the -Contractor - WHEREAS the parties entered into an \,reenrent for Sexual Abuse I reatment (Offense Specific Treatment), (the°1)ri,inal \greement"I identitied by the Weld County Clerk to the Hoard of County Commissioners as document No 201(3-5)577, approved on February S, 25)1 u \\III RI:.:AS the parties hetebv agree to amend the terns of the Original \greenrent in accordance with the terms ots the Uri�inal Agreement, hich is incorporated by reference herein, as r ell as the terms prop ided herein �:REFORI , in consideration or the premises, the parties hereto covenant and agree as • The Original \,reernent will end on \lay 31, 201t? The Amendment, togethem with the Original Agreement, constitutes the entire understandin,, between the parties The folloyving change is hereby made to the Contract Documents 2 1 C1111 This agreement .shall become effective on January I. 25,5 b, upon proper execution of this Agreement and shall expire \lav ; I, 21 I i, unless sooner terminated as provided herein 4 Compensation I'a\inent for ser ices and all related expenses under this Agreement shall not exceed 'bit V. heal 2 Count\ agree; to purchase and Contractor agrees to furnish [RI) units ofOffense Specific meat sertiice at the cost of 7o orb,I our (Individual. Court Facilitation/Court 5laffinnily Team ,AIeetin1camDe Decision \taking \leetin,g Contractor gill only bill for one per month regardless it' multiple meetings are held ) and SOOT (55.), I our (Family) per unit of service for a maximum amount of lo,0rlo 2016-1881 12668-1 ether terms and conditions of the Orieinal A�ereeinent remain unchanLi.o.1 IAA 1t I yFS \V'IILRE-t_)h. the parties hereto have duly executed the \�ereernent as otthe das. rth. and year tryst above +ritten COUNTY: \ 1 LESr1_. �/ 'e0k. BOARD OF COL;A1 1` COti1\IISSIO\ERS Weld 'led: to th Board WELD COI:\TY , COLORADO \like Freeman. Chair JUN 2 0 2016 CON I RAC FOR: FmpoeChoices I hcrapv, LLC 77; > Lincoln Strut, Suite _'!! Den cr. Colorado Sr ; Keith Manchester, ALA_ LP( - O' ner Dare 57/3//‘ AWE �® CERTIFICATE OF LIABILITY INSURANCE 1/7%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 CenterPoint Insurance Group 3900 E. Mexico Ave., #850 Denver CO 80210 CONTACT Kimberl Sorsoleil NAME: Y PHOWC. No. Frtl: (303) 333-0375 I IAIC, Nol: (303)333-1391 ni ss:kim.sorsoleil@cptins.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERA:Philadelphia Insurance 006 INSURED COLORADO DUALLY APPOINTED THERAPIST & REHABILITATION PROVIDERS C/O COLORADO CARE ASSOCIATION 3900 E. MEXICO AVE, SUITE 850 Denver CO 80210 INSURER B : INSURERC: INSURERD: INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER2015-2016 December 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 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 ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MMIDD/YYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY PPK1301025 12/1/2015 12/1/2016 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100,000 X I CLAIMS -MADE OCCUR MED EXP (Any one person) $ 0 X Professional Liability PERSONAL &ADV INJURY $ 1,000,000 * Sexual Abuse GENERAL AGGREGATE $ 5,000,000 GEN'L AGGREGATE —X1 POLICY LIMIT APPLIES jECT PER: LOC PRODUCTS - COMP/OP AGG $ None `SEXUAL ABUSE SUB LIMIT $ 100,000 AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ UMBRELLA LIAB EXCESS LIAB _ OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y I N N / A I TORY LIM U- I l IOT ER E L EACH ACCIDENT $ E . DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ A Privacy Liability HIPAA PPK1301025 12/1/2015 12/1/2016 Per Occurrence 50,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate Holder is Listed as Additional Insured with Respects to: Keith Manchester 975 Lincoln Street, #205 Denver, Co 80203 CERTIFICATE HOLDER CANCELLATION County of Weld County 1150 "O" Street P.O. Box 758 Greeley, CO 80632 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Michael Simms/KRS ACORD 25 (2010/05) INS025 r?nlnnsl 01 © 1988-2010 ACORD CORPORATION. All rights reserved. The, Arnan nnma nn,I Innn nro rcnicfcrnrt morirc of AC(1Rr1 Hello