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Home My WebLink About20161888.tiffCONTRACT AGREEMENT AMENDMENT BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND SHILOH HOUSE (Core/Non-Core) This Agreement Amendment, made and entered into 1ill- day of 2016, by and between the Board of Weld County Commissioners, on behalf of the Weld unty Department of Human Services, hereinafter referred to as the "Department", and Shiloh House, hereinafter referred to as the "Contractor". WHEREAS the parties entered into an Agreement for Day Treatment Services, Life Skills, Home Based Intensive Services, Mental Health Services, and Sexual Abuse Treatment Services, (the "Original Agreement") identified by the Weld County Clerk to the Board of County Commissioners as document No. 201.4-3046, 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. 2015-2907, approved on August 31, 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. ?:7:2:71.-4-76, C: Aule)0A1-e) kisp 4,,,,so-ice 2016-1888 IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first above written. COUNTY: ATTEST: W,dref44) ..eito;e1 BOARD OF COUNTY COMMISSIONERS Weld .unty Clerk to the :oard WELD COUNTY, COLORADO By: Mike Freeman, Chair JUN 2 0 2016 CONTRACTOR: Shiloh House 6588 West Ottawa Avenue Littleton, Colorado 80128 (303) 932-9599 By: Date: 5terbien Ramirez, Chief Executi/Officer oto /6 - /fff SHILHOU-01 RCONTE i4L (-JKL P �- CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 1/6/2016 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 LOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED .PRESENTATIVE 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 CoBiz Insurance, Inc. - CO 821 17th St. Denver, CO 80202 INSURED Shiloh Home, Inc. 6350 W Coal Mine Ave Littleton, CO 80123 CONTACT NAOME; Austin Nike) ac" o E,th (303) 988-0446 FAx (A/c, No/: (303) 988-0804 ADDRESS: CoBizlnsurance@cobizinsurance.com INSURER(S) AFFORDING COVERAGE NAIC it INSURER A : Philadelphia Indemnity Ins. Co 18058 INSURER B : PInnacol Assurance Company 41190 INSURER C : MSURER 0 INSURER E : INSURER F : • • THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY INSR ' __.. _... _.-'ADDL'SUBR- _.. .__ ..- POUCY EFF LTR TYPE OF INSURANCE INS') WVD POLICY NUMBER (MMIDD/YYYY) ..r...+.v.. ,.vmua-rte. TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, PAID CLAIMS. POLICY EXP..... (MM/DOIYYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR X PHPK1439598 01/01/2016 _... _.... _.... GEN'L AGGREGATE LIMIT APPLIES PER: PRO- _. X POLICY ',. LOC JECT OTHER: EACH OCCURRENCE $ 1,000,000 DAMAGETbRENTED 01/01/2017 PREMISESSEaoccurrence) E 1,000,000 MED EXP (Any one person) S 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 3,000,000 PRODUCTS - COMP/OP AGG $ 3,000,000 $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT A X (Ea accident) y 1,000,000 ANY AUTO PHPK1439598 01/01/2016 01/01/2017 BODILY INJURY (Per person) $ ALL OWNED SCHEDULED - - - -- - - - - - . AUTOS AUTOS BODILY INJURY (Per accident)E HIRED AUTOS NON -OWNED '" PROPERTY DAMAGE AUTOS (Per accident) $ E X UMBRELLA UAB X OCCUR EACH OCCURRENCE $ 3,000,000 A EXCESS LIAB CLAIMS -MADE PHUB527079 01/01/2016 01/01/2017 AGGREGATE § 3,000,000 OED X RETENTIONS 10,000 WORKERS COMPENSATION _ AND EMPLOYERS' LIABILITY X PER STATUTE ERH Y /I B ANY PROPRIETOR/PARTNER/EXECUTIVE NE.L. EACH ACCIDENT . 1705662 01/01/2016 01/01/2017 $ 500,000 OFFICER/MEMBER EXCLUDED? N N /A (Mandatory In NH) `--". E.L. DISEASE - EA EMPLOYEE $ 500,000 If yes, describe under .._. ,.... __- DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 500,000 A Management Liability PHSD1008540 01/01/2016 01/01/2017 Mac Aggregate 6,000,000 A Sexual Abuse PHPK1439598 01/01/2016 01/01/2017 Each Abuse Conduct 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101. Additional Remarks Schedule, may be attached N more space Is required) Cyber Liability - Philadelphia Indemnity Ins. Co. Policy #PHSD1106412 eff 09/24/15 to 01/01/17 $1,000,000 limit Weld County, Colorado, by and through the Board of County Commissioners of Weld County, its employees and agents, are included as Additional Insured with respect to General Liability as required by written contract or agreement per the attached form PI-GLD-HS (10/11). 60 day Notice of Cancellation is provided for Weld County. Weld County, Colorado PO Box A Greeley, CO 80632 CANCELLATION 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 i.- 71 ACORD 25 (2014/01) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Hello